两种经皮肾镜手术联合治疗巨大鹿角形肾结石  

Two Combined Invasive Percutaneous Nephrolithotomy Treatment of the Giant Staghom Renal Calculi

作　　者：黄海文 杨水华 陶勇 陈伟光 

机构地区：[1]广东湛江市中心医院泌尿外科,广东湛江524037

出　　处：《河北医学》2010年第7期786-788,共3页Hebei Medicine

摘　　要：目的:探讨微创经皮肾镜手术及新型经皮肾镜手术联合治疗巨大鹿角形肾结石的效果。方法:对57例巨大鹿角形肾结石患者均一期行经皮肾穿刺造瘘,二期行微创经皮肾镜手术及新型经皮肾镜手术联合治疗。其中双侧肾结石9例,合并输尿管上段结石6例,合并脓肾7例,合并梗阻性肾功能衰竭5例,轻度肾积水23例,中重度肾积水34例。结果:57例中单通道取石39例,双通道16例,三通道2例;1次取净结石41例,2次取净结9例,3次取净结石1例,结石取净率为89.5%。平均手术时间为125min,平均出血量30mL,平均住院14.4d,2例术后出现高热(>39℃),其余未见严重并发症。结论:两种经皮肾镜手术联合治疗巨大鹿角形肾结石具有疗效高、创伤小、出血少、安全性好、缩短手术时间及并发症少等优点,尤其对结石合并脓肾、梗阻性肾功能衰竭等全身状况较差的患者更为安全。Objective：To evaluate the minimally invasive percutaneous nephrolithotomy and new combined application of percutaneous treatment of the giant staghom clinical results and methods.Method： 57 patients with giant staghorn calculi in patients with a view to percutaneous renal biosy uniform ostomy： two lines of minimally invasive percutaneous nephrolithotomy and percutaneous nephrolithotomy new combination therapy.9 cases in which bilateral kidney stones combined upper ureteral stones in 6 cases,merged with renal abscess in 7 cases,combined with obstructive renal failure in 5 cases,mild hydronephrosis in 23 cases,moderate and severe hydronephrosis in 34 cases.Result： 57 cases in a single pass to take stones in 39 cases,dual-channel to take stones in 16 cases,three-channel to take stones in 2 cases,a time to take the net stones in 41 cases,2 stones were removed in 9 cases,3 stones were removed in 1 case,the net rate of stone taken 89.5%.The mean operative time was 125 minutes,the average amount of bleeding 30mL,average length of stay 14.4d,2 cases with postoperative high fever（39℃）,no other serious complications.Conclusion： The two kinds of combined application of percutaneous nephrolithotomy in treatment of large staghorn calculi with a safe and effective traumatic small,less bleeding,shorter operative century and the advantages of fewer complications,especially kidney stones combined with renal abscess,obstructive renal function failure,such as poor body condition in patients with more secure.

关 键 词：肾结石 经皮肾镜取石手术 联合应用 

分 类 号：R699[医药卫生—泌尿科学]