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1、微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石的临床分析韩德军(四川省仁寿县人民医院620500)【摘要】目的：分析微创经皮肾镜取石术联合输尿管软镜治疗复余性肾结石的临床疗效及安全性。方法：以我院收治的56例鹿角状肾结石患者为研究对象，所有患者均行微创经皮肾镜取石术联合输尿管软镜治疗。结果：在手术通道建立上，本组56例患者均成功建立微创经皮肾镜取石术工作通道，将所探及的全部结石成功取出。其中，48例(85.71%)患者行单通道取石，8例(14.29%)患者行多通道取石。在手术分期上，一期手术成功率为94.64%(53/56),结石清除率为94.64%(53/56),另3例(5.36%)患者因
2、术中出血量较多经二期输尿管软镜取石术将结石取尽。在手术时间上，本组56例患者平均手术时间为(54.35±19.26)min。在手术并发症发生率上，2例(3.57%)患者出现尿路感染并发症，经抗感染处理后得以控制；未出现尿源性脓毒血症、肠道损伤、肾实质损伤、大出血、胸膜损伤等严重并发症。结论：在微创经皮肾镜取石术治疗的基础上联合应用输尿管软镜取石术可有效提高单通道取石成功率和一期手术取石成功率，避免多通道取石及二期手术取石造成的手术创伤；且并发症少,安全性好，值得临床推广应用。【关键词】复杂性肾结石；微创经皮肾镜取石术；输尿管软镜【中图分类号1R692.4【文献标识码1B【文章编号
3、11003-5028(2015)7-0153-02Analysisoftheminimallyinvasivepercutaneousnephrolithotomycombinedwithsofturetermirrorthecomplexityoftheclinicalefficacyandsafetyofkidneystones【Abstract]objective:toanalyzetheminimallyinvasivepercutaneousnephrolithotomycombinedwithsofturetermirrorthecomplexityoftheclinicaleff
4、icacyandsafetyofkidneystones.Methods:Ourhospitalsof56patientswithstaghornshapekidneystoneswereastheresearchobject,allpatientsweretreatedbytheminimallyinvasivepercutaneousnephrolithotomycombinedwithsofturetermirror.Results:inthechannelbasedontheoperation,thisgroupof56patientsweresuccessfullyestablish
5、edminimallyinvasivepercutaneousnephrolithotomyworkingchannel,willberemovedsuccessfully,andallthestones.Amongthem,48cases(85.71%)patientswithsinglechannellithotomy,8cases(14.29%)patientswithmulti-channellithotomy.Onsurgicalstaging,theissueofsurgicalsuccessratewas94.64%(53/56),stoneclearanceratewas94.
6、64%(53/56),theother3cases(5.36%)patientswithintraoperativebloodlossmorebythesecondphaseofureteralstoneextractionforsoftmirrorstoneswillbetaken.Ontheoperationtime,thisgroupof56patientswithaverageoperationtimewas(54.35±19.26)min.Onthesurgicalcomplications,2patients(3.57%)patientswithurinarytrac
7、tinfectioncomplications,afteranti・infectiontreatmenttocontrol;Doesnotappearurinesourcesexsepsis,intestinalinjury,renalparenchymainjury,hemorrhage,pleuraldamageandotherseriouscomplications.Conclusions:
