Clinical Study Of Mini-percutaneous Nephrolithotomy And Antegrade Flexible Ureteroscopy In The Treatment Of Complicacy Kidney Stone

Background Complicacy Kidney Stone refers to staghorn renal calculi,multiple kidney stones,calculi with renal neck constriction or renal calyx dilatation or abnormal renal pelvis anatomy,such as horseshoe kidney stones,sponge kidney stone.The treatment of complicated renal calculi has been a difficult problem in the department of urology.It is the purpose of the treatment to keep the stone free rate,reduce the recurrence rate and infection rate,and protect the renal function.With the rapid development of minimally invasive techniques in the department of Urology,percutaneous nephrolithotomy treatment of complex renal calculi become preferred,especially has significant effect in treatment of multiple stones and large stones,standard channel percutaneous nephrolithotomy effect is high,but the standard channel is thick,swing easy bleeding light neck tear,leading to bleeding.On this basis,a minimally invasive percutaneous nephrolithotomy(PCNL).Single channel MPCNL pneumatic lithotripsy is often unable to completely detect or completely remove stones.The high rate of stone removal can be obtained by multi channel stone extraction,but it is easy to damage the renal parenchyma and increase the complications.Therefore,how to reduce the surgical trauma and improve the stone clearance rate has become the focus of clinical attention.Objectives Explore the single channel of minimally invasive percutaneous nephroscope pneumatic ballistic lithotripsy joint soft ureter mirror complexity of holmium laser lithotripsy treatment the clinical efficacy and safety of kidney stones.Methods From March 2015 to July 2015 in our hospital,96 cases of complex kidney stone patients were randomly divided into two groups,48 cases in the each group.In the matched group,with single channel MPCNL pneumatic ballistic lithotripsy treatment,observation group single channel MPCNL pneumatic ballistic lithotripsy combined holmium laser lithotripsy treatment soft ureter mirror.All patients were given KUB,Ultrasound of uropoietic system,IVU or CTU before operative.Two groups of patients' age,gender,stone size,leucocyte positive rate of urine routine,positive rate of urine culture no statistical difference.Statistical analysis of two groups of patients with calculi clearance rate,operation time,postoperative hemoglobin,postoperative infection,postoperative urine turns time,complications and length of hospital stay,hospital expenses etc.Results Observation group total effective rate is 93.75%(45 / 48)significantly higher than 77.10%(37 / 48)of the control group and significant difference(P < 0.05);Observation group operating time(58.1 ±25.2 min)than the control group operating time(46.8 ± 20.5 min),with statistical significance(p < 0.05);Observation group compared with the control intraoperatie bleeding,postoperative infection,the time of urine turns clear after operative,30 min after blood leukocytes no obvious statistical significance compared with preoperative,postoperative 1 h,2 h more preoperative elevated white blood cell(P < 0.05).Preoperative routine urine leucocyte unusually high incidence of postoperative infection,with statistical significance(P < 0.05).Observation group and control group hospitalization expenses increased(P < 0.05),but no significantly extend the length of hospital stay(P > 0.05).Conclusion Single channel MPCNL pneumatic ballistic lithotripsy combined renal colostomy soft ureter mirror holmium laser lithotripsy treatment curative effect is complexity,kidney stones and can obviously improve the effect of stone removal.