CAJ | 학술논문

目的：分析标准经皮肾镜(PCNL)联合输尿管镜治疗鹿角形肾结石的疗效。方法回顾性分析2010年6月~2015年2月在我院泌尿外科采用PCNL联合输尿管镜进行治疗的126例鹿角形肾结石患者的临床资料。所有患者行PCNL联合输尿管镜碎石取石术治疗。记录并分析患者术前、术中和术后的相关资料。同时，选取行单纯PCNL治疗鹿角形肾结石患者89例为对照组。比较两组患者相关参数和疗效差异。结果 PCNL联合输尿管镜组患者手术时间、出血量及并发症发生率显著低于对照组(P<0.05)，一期结石取净率显著高于对照组(P<0.05)。 PCNL联合输尿管镜组患者术后27例出现发热，术后1例出现严重出血，未出现集合系统撕裂或穿孔、胸膜、肠管及重要血管损伤。13例残余结石肾再次行该手术治疗，术后复查无结石残留；48例肾结石术后随访6~36个月未见结石复发。结论超声引导下PCNL联合输尿管镜治疗鹿角形肾结石安全有效，是其治疗理想的选择。
목적：분석표준경피신경(PCNL)연합수뇨관경치료록각형신결석적료효。방법회고성분석2010년6월~2015년2월재아원비뇨외과채용PCNL연합수뇨관경진행치료적126례록각형신결석환자적림상자료。소유환자행PCNL연합수뇨관경쇄석취석술치료。기록병분석환자술전、술중화술후적상관자료。동시，선취행단순PCNL치료록각형신결석환자89례위대조조。비교량조환자상관삼수화료효차이。결과 PCNL연합수뇨관경조환자수술시간、출혈량급병발증발생솔현저저우대조조(P<0.05)，일기결석취정솔현저고우대조조(P<0.05)。 PCNL연합수뇨관경조환자술후27례출현발열，술후1례출현엄중출혈，미출현집합계통시렬혹천공、흉막、장관급중요혈관손상。13례잔여결석신재차행해수술치료，술후복사무결석잔류；48례신결석술후수방6~36개월미견결석복발。결론초성인도하PCNL연합수뇨관경치료록각형신결석안전유효，시기치료이상적선택。
Objective To analyze the efficacy of percutaneous nephrolithotomy (PCNL)combined with ureteroscopy in treatment of renal staghorn calculi. Methods The data of 126 patients with renal staghorn calculi were retrospectively analyzed in the department of urinary surgery of our hospital. All patients were treated with PCNL combined with ureteroscopy. The related data of preoperative, intraoperative and postoperative were recorded and analyzed. Mean-while, 89 patient with renal staghorn calculi treated by PCNL were selected as control group. The related parameters between two groups were compared. Results Compared with control group,the operation time, amount of bleeding and complication rate of PCNL combined with ureteroscopy group were lower(P<0.05), the stone clearance rate of PCNL combined with ureteroscopy group was higher(P<0.05). Among of PCNL combined with ureteroscopy group,27 patients suffered from fever after surgery and 1 patient had hemorrhage. No renal collection system tear or perforation,damaged pleura, bowel and major vessel occurred. 15 patients had residual stones and were treated by two-stage operation. 48 cases were followed up from postoperative 6-36 months and there wasn't stone recurrence. Conclusion PCNL com-bined with ureteroscopy guided by ultrasound is a good choice in treatment of renal staghorn calculi.