摘要
目的探讨总结经皮肾气压弹道碎石手术治疗复杂性肾结石的临床疗效。方法回顾性分析162例采用经皮肾气压弹道碎石手术治疗复杂性肾结石患者的临床资料,观察其临床疗效。结果①手术情况:162例患者中152例采用单通道取石, 10例采用双通道取石;术中无一例输血患者;术后160例患者造瘘管出血轻微, 2例患者出血凶险行介入治疗止血后痊愈;其中2例血气胸患者经胸腔负压闭式引流3 d复查无异常后拨除负压管。手术时间0.5~3.0 h,平均手术时间(1.5±0.5)h;平均失血量(60±2)ml;平均住院时间(10±1)d。②拨除肾瘘管及结石清除情况:102例一期碎石患者于术后5~7 d予以拨除肾瘘管, 60例二期碎石患者于一期术后第3~5天行二期碎石,并在二期碎石术后2~3 d予以拨除肾瘘管。术后第3天结石清除率为83.3%(135/162),术后1个月结石清除率为92.6%(150/162)。③并发症发生及造瘘口愈合情况:162例患者术后无肾脏穿通伤、感染性休克及周围器官损伤等并发症发生。术后随访1个月所有患者无肾造瘘口漏尿及延迟愈合、无继发性大出血等并发症发生。所有患者造瘘口甲级愈合。结论经皮肾气压弹道碎石手术治疗复杂性肾结石具有疗效确切、结石清除率高、手术时间短、术后恢复快、术后并发症发生率低等优势,值得临床广泛推广应用。
Objective To discuss and summarize the clinical efficacy of percutaneous renal pneumatic lithotripsy for the treatment of complex renal calculi. Methods The clinical data of 162 complex renal calculi patients treated by percutaneous renal pneumatic lithotripsy was retrospectively analyzed and their clinical efficacy was observed. Results ①Surgical situation: 152 cases received single-channel lithotripsy and 10 cases received double-channel lithotripsy among 162 patients. No patients received blood transfusion during the operation. 160 patients had slight hemorrhage after the operation, and 2 patients were cured after dangerous interventional therapy for hemostasis. 2 pneumohemothorax patients were treated with closed drainage via thoracic negative pressure for 3 d, and the negative pressure tube was removed when no abnormality, with operation time as 0.5-3.0 h, average operation time as(1.5±0.5) h, average blood loss as(60±2) ml and average hospitalization time as(10±1) d.②Removal of renal fistula and calculus removal: renal fistula was removed in 102 patients with first stage lithotripsy at 5-7 day after operation. 60 patients underwent second stage lithotripsy at 3-5 days after first stage lithotripsy, and the renal fistula was removed after second stage lithotripsy. Calculus clearance rate was 83.3%(135/162) at 3 day after operation and 92.6%(150/162) at 1 month after operation.③Complications and healing of stoma: no complications such as penetrating renal injury, septic shock and peripheral organ injury occurred in 162 patients after operation. No complications such as leakage of urine, delayed healing and secondary massive hemorrhage occurred during the follow-up of 1 month after operation. All patients had a grade A healing of the fistula. Conclusion Percutaneous renal pneumatic lithotripsy has the advantages of definite efficacy, high clearance rate of calculus, short operation time, quick recovery and low incidence of complications. It is worthy of wide clinical promotion and application.
作者
陈上保
李伟民
邱树波
黎伟强
CHEN Shang-bao;LI Wei-min;QIU Shu-bo(Guangdong Xinxing County Hospital of Traditional Chinese Medicine, Yunfu 527400, China)
出处
《中国实用医药》
2019年第25期19-21,共3页
China Practical Medicine
关键词
经皮肾气压弹道碎石手术
复杂性肾结石
疗效
Percutaneous renal pneumatic lithotripsy
Complex renal calculi
Efficacy
