34例鹿角形肾结石手术取石的疗效观察  

Results of 34 cases of removal for complex staghorn renal calculi

作　　者：曾志宇 江伟东 俞明辉 夏金山 欧阳少青 

机构地区：[1]珠海市拱北医院泌尿外科,广东珠海519020 [2]广东省河源市人民医院泌尿外科

出　　处：《医学信息（西安上半月）》2005年第7期795-797,共3页Medical Information

摘　　要：目的探讨肾下极肾盂肾盏联合切开术治疗复杂性鹿角形肾结石的疗效。方法回顾性分析采用肾下极肾盂肾盏联合切开术式治疗复杂性鹿角形肾结石34例临床资料。手术方法:分离肾窦内肾盂后,用1-0肠线在肾后唇中下1/3连接处紧贴肾盂肾盏表面缝合肾实质2针,中间尖刀切开肾实质,然后弧形切开肾盂及肾下盏,用神经剥离子将结石与肾盂肾盏粘膜粘连分离后,取石钳夹住结石轻轻撬出。盏颈狭窄者必要时先用气压弹道碎石器将其在分支处击断。4-0肠线缝合肾盂及肾下盏,再用2-0肠线间断全层缝合肾实质切口数针,包膜层用4-0肠线缝合。结果34例均一次性取净结石。术中平均出血量约90ml。术后无大出血病例。结论肾下极背侧肾实质与肾盂联合切开取石术具有术中出血少,无须阻断肾蒂,肾功能受损轻,便于一次取尽结石等优点。适合于肾窦内肾盂特别是肾下盏盏颈相对狭窄的复杂性鹿角形肾结石的治疗。Objective To evaluate the lower pole pyelocalycolithotomy for the re moval of complex staghorn renal calculi. Methods A retrospective review of 34 c ases of complex staghorn renal calculi treated by lower pole pyelocalycolithoto my was performed. Results The calculi were completely removed in all the 34 cas es.the mean amount of bleeding was 90ml,and had no patients bleeding much. Conc lusions This procedure has the advantages of little intraoperative bleeding,and needn't cut off the renal blood flow,slight impairment of renal function,high clearence rate and is indicated for the removal of any intrarenal pelvis complex staghorn calculi espespiatialy combined with a narrow lower calyci neck.

关 键 词：鹿角形肾结石 疗效观察 手术取石 联合切开取石术 肾窦内肾盂 肾盂肾盏 间断全层缝合 联合切开术 回顾性分析 平均出血量 肾功能受损 肾实质 复杂性 肾下极 肾下盏 临床资料 切开术式 手术方法 弧形切开 粘连分离 气压弹道 

分 类 号：R692.4[医药卫生—泌尿科学] R699.2[医药卫生—外科学]