摘要
目的观察标准通道硬镜主导软硬镜联合治疗肾脏复杂结石的临床效果。方法回顾性分析2013年2月—2014年3月于我院住院治疗采用标准通道硬镜主导软硬镜联合碎石术的肾脏复杂结石60例的临床资料,包括手术时间、碎石时间、出血量及结石清除率等指标。结果本组均一期穿刺建立标准通道并成功实施手术,平均手术时间65 min,平均碎石时间40 min,平均术中估计出血量60 ml。2例出现肾周积液者经保守治疗后好转;4例术后48 h内发热,给予抗感染等对症治疗后缓解;无胸腔积液及肠管损伤等严重并发症发生,无需输血或介入手术止血患者。术后第2天行尿路X线平片检查评估碎石效果,结石清除率96.8%,2例2侧经2次手术碎石后结石清除干净。本组平均住院时间6 d。结论标准通道硬镜主导软硬镜联合治疗肾脏复杂结石具有较高结石清除率和较低并发症发生率,且可明显缩短手术时间和住院时间。
Objective To observe clinical effect on standardized renal access rigid nephroscope combined with flexible ureteroscopy in treatment of complicated renal calculi. Methods During February 2013 and March 2014,60 cases of complicated renal calculi under standardized renal access rigid nephroscope combined with flexible ureteroscopy lithotripsy were included in the study. Clinical data were retrospectively analyzed including operative time,crushed stone time blood loss,stone free rate and other indicators. Results All the patients were successful in establishing standardized renal access,the average operation time was 65 min,the average time of lithotripsy was 40 min,the average intraoperative estimated blood loss was 60 ml. After conservative treatment,2 cases of complicated perirenal effusion improved. 4 cases had postoperative fever within 48 h,but had remission after anti infection and other symptomatic treatment. No severe complications such as pleural effusion and intestinal injury occurred. No patients underwent blood transfusion and interventional surgery. On day 2 after operation,X-ray film of urinary tract was used to evaluate the effect of lithotripsy. The stone free rate was 96. 8%,2 cases（ 2sides） had a second operation and the stones were completely removed. The average hospital stay was 6 d. Conclusion Standardized renal access rigid nephroscope combined with flexible ureteroscopy in treatment of complicated renal calculi is safer and more efficient and can obviously shorten the operation time and hospital stay.
出处
《临床误诊误治》
2016年第8期63-65,共3页
Clinical Misdiagnosis & Mistherapy
关键词
肾结石
肾造口术
经皮
Kidney calculi
Nephrostomy
percutaneous
