微创经皮肾镜取石术治疗泌尿系软结石的疗效及安全性分析  

Clinical Evaluation and Precautions of the Treatment of Urinary Soft Calculi with Minimally Invasive Percutaneous Nephrolithotomy

作　　者：杨文增[1] 王佳荣[1] 赵春利[1] 

机构地区：[1]河北大学附属医院泌尿外科,河北省保定市071000

出　　处：《中国全科医学》2012年第2期207-208,共2页Chinese General Practice

摘　　要：目的评价微创经皮肾镜取石术治疗泌尿系软结石的安全性及可行性,探讨防范风险的应对措施。方法回顾性分析2010年5月—2011年4月我院收治的12例泌尿系软结石患者的临床资料,结石大小3.3 cm×2.6 cm～10.5 cm×4.6 cm,均采用微创经皮肾镜取石术治疗。结果采用单通道Ⅰ期平均手术时间为115 min,术中平均出血量为100 ml,平均住院天数为13 d,结石总取净率为83.3%(10/12)。术后并发高热2例,结石残留2例。结论微创经皮肾镜取石术治疗泌尿系软结石具有创伤小、结石清除率高、恢复快等优点。围术期积极处理并存病,术前有效抗感染,术中及时降低肾盂内压,术后保证引流通畅等措施是减少并发症的关键,术中应用取石钳钳夹的方法可提高结石清除率。Objective To assess the feasibility and safety of the treatment of urinary soft calculi with minimally invasive percutaneous nephrolithotomy（MPCNL） and to explore the risk and precautions of MPCNL for urinary soft calculi. Methods Clinical data of 12 patients with urinary soft calculi treated by MPCNL at our hospital from May 2010 to April 2011 were analyzed retrospectively.The stone burden ranged from 3.3 cm×2.6 cm to 10.5 cm×4.6 cm.All stones were treated via MPCNL. Results Performed via single channel,the mean operating time was 115 minutes,blood loss was 100 ml and average hospital stay was 13 days.The total stone-free rate was 83.3%（10/12）,with high fever occurred in 2 cases and residual stones observed in 2 cases. Conclusion MPCNL is a feasible and safe technique with less injury,higher stone-free rate,and quicker recovery in treating urinary soft calculi.Perioperative management of the coexisting diseases,effective anti-infection,maintaining renal intrapelvic pressure,guarantee of postoperative urinary tract unobstruction are essential to decreasing the incidence of complications.Intraoperative application of lithotomy forceps method can increase the stone-free rate.

关 键 词：肾结石 肾造口术 经皮 外科手术 

分 类 号：R692.4[医药卫生—泌尿科学]