摘要
目的探讨Ⅰ期微创经皮肾镜取石术（minimally invasive percutaneous nephrolithotomy,MPCNL）治疗结石性脓肾的疗效。方法 2005年11月-2010年1月,Ⅰ期MPCNL治疗结石性脓肾23例。23例均有患侧腰痛,伴发热。输尿管上段结石8例,肾盂结石9例,肾盂结石并下盏结石6例。右侧13例,左侧10例。均行Ⅰ期MPCNL治疗。结果平均手术时间56min（40-90min）。20例一次碎石取石成功,Ⅰ期结石清除率87%（20/23）;3例合并下盏〉1cm结石,在病情稳定后行Ⅱ期经皮肾取石术取出。未发生感染加重、脓毒血症、休克等并发症。随访13例,随访时间3-12个月,平均6个月,患肾功能均恢复,均无肾萎缩。结论选择合适病例,注意术中操作技巧,Ⅰ期MPCNL治疗结石性脓肾安全,疗效确切,恢复快。
Objective To evaluate the safety and efficacy of stage-Ⅰ minimally invasive percutaneous nephrolithotomy（MPCNL）for the treatment of upper urinary calculi complicated with pyonephrosis.Methods From November 2005 to January 2010,a total of 23 patients with upper urinary calculi complicated with pyonephrosis were treated with stage-Ⅰ MPCNL.Of the patients,8 had upper ureteral calculi,9 showed renal pelvis calculi,6 suffered from renal pelvis calculi complicated with lower calyx calculi;pyonephrosis were detected at the right side in 13 cases,and left side in 10.All of the patients complained of low back pain at the affected side and fever.Results The mean operation time was 56 minutes（ranged from 40 to 90 minutes）in our patients.The stones were removed on one session in 20 cases（87%,20/23）.In the other 3 patients who were complicated with lower calyx calculi 1 cm in diameter were cured with a second procedure.No patients had aggravated infection,sepsis or shock.Thirteen of the patients were followed up for 3 to 12 months（mean,6 months）,during which their renal function of the affected side all recovered without atrophy.Conclusion Stage-Ⅰ MPCNL is an effective,quick-recovery and safe treatment for upper urinary calculi complicated with pyonephrosis,as long as we stick to the indications and standard procedures for the operation.
出处
《中国微创外科杂志》
CSCD
2010年第12期1101-1103,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
结石
脓肾
微创经皮肾镜取石术
Calculi
Pyonephrosis
Minimally invasive percutaneous nephrolithotomy
