经皮肾穿刺取石术中经肋间穿刺的安全性评估  

Safety Evaluation of Intercostal Puncture in Percutaneous Nephrolithotomy

作　　者：尹光明[1] 戴英波[1] 蒋先镇[1] 蒋志强[1] 钟狂飚[1] 曾青[1] 何乐业[1] 

机构地区：[1]中南大学湘雅三医院泌尿外科,湖南省长沙市410013

出　　处：《中国全科医学》2008年第14期1282-1283,共2页Chinese General Practice

摘　　要：目的评价经皮肾穿刺取石术中经肋间穿刺途径的安全性和有效性。方法我科2007年1—9月共行经皮肾穿刺取石术231例,其中97例(42%)为经肋间穿刺建立通道。观察行肋间穿刺患者的结石清除率及其并发症。结果97例经肋间穿刺患者的结石清除率为71.3%(69/97例);并发症发生率13.4%(13/97例):其中严重出血5例,有4例需要输血,胸腔积液3例,选择性肾动脉栓塞1例,感染性休克1例。结论经第11肋间进行穿刺存在一定风险,需严格掌握适应证,术后应常规进行胸片检查以排除胸部并发症。Objective To evaluate retrospectively the safety and efficacy of intercostal puncture in percutaneous nephrolithotomy （PCNL）. Methods There were a total of 231 patients undergoing PCNL, in 97 of whom tunnels were established for intercostal puncture （42%）. Data of stone clearance and complications of patients undergoing intercostal puncture were analyzed. Results In 97 intercostal puncture patients, stone clearance was 71.3 % （69/97） ; incidence rate of complications was 13.4% （13/97） five of them presented with severe bleeding, 3 with pleural effusion, 1 with selective thrombosis of renal artery, 1 with septic shock, and 4 needed blood transfusion. All patients recovered uneventfully. Conclusion These results indicate that intercostal puncture is used widely in spite of some acceptable complications. A chest X - ray after surgery should be routine, to detect any complication.

关 键 词：肋间穿刺 尿路结石 手术后并发症 

分 类 号：R691.4[医药卫生—泌尿科学]