摘要
目的探讨经皮肾镜取石术治疗肾切开取石术后复发或残留肾结石的疗效及安全性。方法回顾性分析2008年9月至2010年1月肾切开取石术后复发或残留肾结石患者48例，均行经皮肾镜取石术治疗，其中气压弹道碎石21例，气压弹道联合超声碎石23例，双导管碎石4例。结果48例均一期手术成功，单通道取石39例，双通道取石8例，三通道取石1例。平均手术时间74min，平均术中出血量138．6mL，平均住院时间10d，一次结石清除率89．58％（43／48），3例行二次取石清除残余结石，2例行体外冲击波碎石治疗。1例严重出血行超选择性肾动脉栓塞术治疗好转。无其他严重并发症。随访3－15个月无复发。结论经皮肾镜取石术治疗肾切开取石术后复发或残留结石具有创伤小、术后恢复快、安全性高等优点。可作为首选治疗方法。
Objective To explore the efficacy and safety of the recurrent or residual renal calculus with a history of open nephrolithotomy treated with percutaneous nephrolithotomy. Methods The data of 48 cases with recurrent or residual renal calculus with a history of open nephrolithotomy from September 2008 to January 2010 were analyzed retrospectively. All patients were treated with percutaneous nephrolithotomy 21 cases were treated with pneumatic lithotripsy, 23 cases with combined pneumatic and ultrasound lithotripsy and 4 cases with dual probe ultrasonic lithotripsy. Results All the cases were cured successfully in one stage. 39 renal units were cured by one tunnel way, 8 renal units by double tunnel and 1 renal unit by multiple tunnel. The average time for whole surgery was 74 min. The average bleeding volume was 138.6 mL. The average hospital stay was l0 days. The calculi clearance rate was 89.58% （43/48） while 3 cases with residual calculus underwent second neohroscopy and 1 case was cued by ESWL. 1 case with severe hemorrhage was cured by superselective renal artery embolization. No other complication occurred and no recurrence was found in 3 to 15 months＇ follow-up. Conclusion Percutaneous nephrolithotomy is an effective and feasible therapeutic option for patients with recurrent or residual renal calculus after open operation for its advantages of less invasiveness and complications, shorter duration for hospitalization and high safety.
出处
《医学研究与教育》
CAS
2013年第4期10-13,共4页
Medical Research and Education
关键词
经皮肾镜取石术
肾结石
复发结石
残留结石
percutaneous nephrolithotomy
kidney calculi
recurrent calculus
residual calculus
