患侧朝上斜仰截石位和截石位输尿管软镜钬激光碎石术治疗肾下盏结石的有效性和安全性比较(1)
DOI：10.16662/j.cnki.1674-0742.2017.11.037
[摘要] 目的 比較患侧朝上斜仰截石位和截石位输尿管软镜钬激光碎石术(F-URS)治疗肾下盏结石的有效性和安全性。方法 回顾性分析2014年10月—2016年8月龙岩市第二医院泌尿外科结石中心接收的90例结石F-URS治疗肾下盏结石患者的临床资料。根据手术体位，将患者分为两组：患侧朝上斜仰截石位组48例，截石位组42例。对两组总手术时间、失血量、发热等并发症的发生率及结石清除率等进行比较。结果 90例手术均取石术前先放置F8双J管2周，二期 输尿管软镜钬激光碎石放置输尿管软镜输送鞘均放置成功。二期斜仰截石位体位组总手术时间为(36.4±10.1)min，短于截石位组的(50.1±14.3)min，差异有统计学意义(P<0.05)。血红蛋白下降值分别为(0.6±0.4)g/L和(0.7±0.3)g/L，差异无统计学意义。但发热并发症发生率分别为2%(1/48)和14%(6/42)及结石清除率分别为94%(45/48)和71%(30/42)，比较差异有统计学意义(P<0.05)。结论 患侧朝上斜仰截石位比截石位治疗肾下盏结石更安全有效，手术时间短。
[关键词] 输尿管软镜手术；斜仰截石位；截石位；回顾性研究
[中图分类号] R45 [文献标识码] A [文章编号] 1674-0742(2017)04(b)-0037-04
Comparison of Effectiveness and Safety of Affected Side Up Oblique Lithotomy Position and Dorsosacral Position Flexible Ureteroscopic Lithotripsy Holmium Laser Lithotripsy in Treatment of Stone in Lower Renal Calices
ZENG Zhi-hui， CHEN Guo-qiang， ZHU Xiao-ling， LI Guang-hai， ZHANG Qiu-yan， FAN Da-yuan
Stone Center， Department of Urine Surgery， Longyan Second Hospital， Longyan， Fujian Province， 364000 China
[Abstract] Objective To compare the effectiveness and safety of affected side up oblique lithotomy position and dorsosacral position flexible ureteroscopic lithotripsy holmium laser lithotripsy in treatment of stone in lower renal calices. Methods 90 cases of patients with subrenal calyx calculus admitted in our hospital from October 2014 to August 2016 were selected and divided into the affected side up lithotomy position group with 48 cases and lithotomy position group with 42 cases according to the operation body positon， and the total operation time， blood loss and incidence rate of complications such as fever and clearance rate of stones were compared between the two groups. Results 90 cases were placed with the F8 dual J tube for two weeks before the lithotripsy， the flexible ureteroscopic lithotripsy were placed successfully in the second stage， and the total operation time in the secondary oblique lithotomy position group was shorter than that in the lithotomy position group， [(36.4±10.1)min vs (50.1±14.3)min]， and the difference was statistically significant(P<0.05)， and the difference in the decrease value of haemoglobin between the two groups was not statistically significant， [(0.6±0.4)g/L vs (0.7±0.3)g/L]， but the differences in the incidence rate of complications such as fever and stone clearance rate between the two groups were statistically significant， [2%(1/48)] vs [14%(6/42)] and [94%(45/48)] vs [71%(30/42)]， and the differences between groups were statistically significant(P<0.05). Conclusion The affected side up oblique lithotomy position in treatment of stone in lower renal calices is more safe and effective than the lithotomy position， and the operation time is shorter., 百拇医药(曾智辉 陈国强 朱小玲 李广海 张秋燕 范大渊)
[摘要] 目的 比較患侧朝上斜仰截石位和截石位输尿管软镜钬激光碎石术(F-URS)治疗肾下盏结石的有效性和安全性。方法 回顾性分析2014年10月—2016年8月龙岩市第二医院泌尿外科结石中心接收的90例结石F-URS治疗肾下盏结石患者的临床资料。根据手术体位，将患者分为两组：患侧朝上斜仰截石位组48例，截石位组42例。对两组总手术时间、失血量、发热等并发症的发生率及结石清除率等进行比较。结果 90例手术均取石术前先放置F8双J管2周，二期 输尿管软镜钬激光碎石放置输尿管软镜输送鞘均放置成功。二期斜仰截石位体位组总手术时间为(36.4±10.1)min，短于截石位组的(50.1±14.3)min，差异有统计学意义(P<0.05)。血红蛋白下降值分别为(0.6±0.4)g/L和(0.7±0.3)g/L，差异无统计学意义。但发热并发症发生率分别为2%(1/48)和14%(6/42)及结石清除率分别为94%(45/48)和71%(30/42)，比较差异有统计学意义(P<0.05)。结论 患侧朝上斜仰截石位比截石位治疗肾下盏结石更安全有效，手术时间短。
[关键词] 输尿管软镜手术；斜仰截石位；截石位；回顾性研究
[中图分类号] R45 [文献标识码] A [文章编号] 1674-0742(2017)04(b)-0037-04
Comparison of Effectiveness and Safety of Affected Side Up Oblique Lithotomy Position and Dorsosacral Position Flexible Ureteroscopic Lithotripsy Holmium Laser Lithotripsy in Treatment of Stone in Lower Renal Calices
ZENG Zhi-hui， CHEN Guo-qiang， ZHU Xiao-ling， LI Guang-hai， ZHANG Qiu-yan， FAN Da-yuan
Stone Center， Department of Urine Surgery， Longyan Second Hospital， Longyan， Fujian Province， 364000 China
[Abstract] Objective To compare the effectiveness and safety of affected side up oblique lithotomy position and dorsosacral position flexible ureteroscopic lithotripsy holmium laser lithotripsy in treatment of stone in lower renal calices. Methods 90 cases of patients with subrenal calyx calculus admitted in our hospital from October 2014 to August 2016 were selected and divided into the affected side up lithotomy position group with 48 cases and lithotomy position group with 42 cases according to the operation body positon， and the total operation time， blood loss and incidence rate of complications such as fever and clearance rate of stones were compared between the two groups. Results 90 cases were placed with the F8 dual J tube for two weeks before the lithotripsy， the flexible ureteroscopic lithotripsy were placed successfully in the second stage， and the total operation time in the secondary oblique lithotomy position group was shorter than that in the lithotomy position group， [(36.4±10.1)min vs (50.1±14.3)min]， and the difference was statistically significant(P<0.05)， and the difference in the decrease value of haemoglobin between the two groups was not statistically significant， [(0.6±0.4)g/L vs (0.7±0.3)g/L]， but the differences in the incidence rate of complications such as fever and stone clearance rate between the two groups were statistically significant， [2%(1/48)] vs [14%(6/42)] and [94%(45/48)] vs [71%(30/42)]， and the differences between groups were statistically significant(P<0.05). Conclusion The affected side up oblique lithotomy position in treatment of stone in lower renal calices is more safe and effective than the lithotomy position， and the operation time is shorter., 百拇医药(曾智辉 陈国强 朱小玲 李广海 张秋燕 范大渊)