摘要
目的：：提高运用微通道经皮肾镜气压弹道碎石术术治疗感染性鹿角形肾结石的能力.方法：2009年1月~2014年6月,共有73例(77侧)感染性鹿角形肾结石患者接受微通道经皮肾镜气压弹道碎石术术治疗.回顾性分析此73例患者的临床资料,统计手术时间、术后血红蛋白(Hb)下降值、术后输血率、一期结石清除率、术后发热发生率以及并发症发生情况.结果：73例(77侧)患者均成功建立一期经皮肾通道并完成一期取石手术.手术时间为51.7~212.0 min,平均(102.3±42.2)min.Hb 下降值为9~47 g/L,平均(17.3±5.4)g/L.7.8％(6/77)术后接受了输血.一期结石清除率为74.0％(57/77),结合体外冲击波碎石(ESWL)治疗一期结石清除率为81.8％(63/77).术后发热发生率为10.4％(8/77).1例患者因为输血治疗无效行超选择性肾动脉栓塞止血,1例患者发生尿脓毒症休克,无周围器官损伤发生,无死亡病例.结论：在充分掌握手术技巧、完善术前风险控制和术后管理的前提下,微通道经皮肾镜气压弹道碎石术术治疗感染性鹿角形肾结石不失为一种安全有效的方法.
Objective:To improve the ability of treat infectious staghorn calculi with micro-channel percutaneous pneumatic lithotripsy.Methods:From 2009 january to 2014 june,there were 73patients(77sides)with infectious staghorn calculi underwent micro-channel percutaneous pneumatic lithotripsyin our hospital.We analyze the clinical data of the 73 patients retrospectively,count the operation time,decrease of Hb,transfusion rate,one-staged stone clearance rate,incidence of postoperative fever and complications.Results:Allpercutaneous renal accesses in 73cases(77sides)were successfully established and the one-staged percutaneous nephrolithotomy were performed.The operation time of the one-staged percutaneous nephrolithotomyranged from 51.7to 212.0min,average(102.3±42.2)min.The decrease of Hbranged from 9to 47g/L,average(17.3±5.4)g/L.7.8%(6/77)operations received blood transfusion.The one-staged stone clearance rate was 74.0%(57/77)and the one-stagedclearance rate increased to81.8%(63/77)after ESWL.Postoperative fever incidence was 10.4%(8/77).1patient received super selective renal artery embolization.1patient had uroseptic shock,no peripheral organ damage and no deaths.Conclusions:In condition that operation skills are fully mastered,the preoperative risk is controlled and the postoperative management is improved,its a safe and effective method to treat infectious staghorn calculi with micro-channel percutaneous nephrolithotomy pneumatic lithotripsy,It is worth recommending.
出处
《微创泌尿外科杂志》
2014年第5期290-295,共6页
Journal of Minimally Invasive Urology
关键词
感染性鹿角形肾结石
微通道
经皮肾镜取石术
气压弹道碎石
疗效
infectious staghorn calculi
micro-channel
percutaneous nephrolithotomy
pneumatic lithotripsy
efficacy
