第10～11肋间入路经皮肾镜碎石术治疗多发性肾结石疗效观察  

Effective observation on percutaneous nephrolithotripsy by approach through 10-11 intercostals for treating complex renal stones

作　　者：孙之鹏[1] 高佃军[2] 栾志敏[2] 刘伟光[2] 王琦[2] 

机构地区：[1]潍坊医学院,山东潍坊261042 [2]潍坊医学院附属医院泌尿外科,山东潍坊261031

出　　处：《现代医药卫生》2012年第4期510-511,共2页Journal of Modern Medicine & Health

摘　　要：目的探讨B超引导下第10～11肋间入路经皮肾镜碎石术治疗多发性肾结石的临床效果。方法选择多发性肾结石患者50例,其中观察组22例,采用第10～11肋间入路,对照组28例,采用第12肋下入路,均用气压弹道联合超声碎石,对两组手术时间、术中出血量、一次性结石清除率、并发症、术后住院时间进行比较。结果与对照组相比,观察组一次性碎石成功率较高(分别为81.9%和78.6%),手术时间较长[分别为(97.65±9.78)min和(86.43±9.35)min],术中出血量较多[分别为(103.45±6.59)ml和(95.27±7.56)ml],气胸发生率较高(13.6%、0%),差异均有统计学意义(P<0.05)。结论第10～11肋间入路经皮肾镜治疗多发性肾结石Ⅰ期结石清除率较高,手术时间较长,出血量较多,有发生气胸的可能,但熟练掌握后可作为经皮肾镜技术的一种选择。Objective To evaluated the clinical effects of B-type ultrasound mediated percutaneous nephrolithotripsy（PCNL） by approach through 10-11 intercostals on the patients with complex renal stones.Methods 50 cases of complex renal stones were taken into the trial.22 cases in the observation group adopted the approach through 10-11 intercostals,while the other 28 cases in the control group were performed the approach through 12 intercostal.All the cases accepted PCNL associated by pneu matic and ultrasound lithotripsy.The blood loss,one-time stone-free rate,complication and stay time after operation were compared between the two groups.Results Compared with the control group,the one-time stone-free rate in the observation group was higher（81.9% vs.78.6%,P0.05）,the time of surgery was longer [（97.65±9.78） min vs.（86.43±9.35） min,P0.05],pneumothorax probability was higher（13.6% vs.0%,P0.05）,and the blood loss was more [（103.45±6.59）ml vs.（95.27±7.56,P0.05 ml].Conclusion PCNL by approach through 10-11 intercostal achieves higher stone-free rate,longer operation time and more intraoperative blood loss with pneumothorax probability,but which may be as an option of percutaneous nephroscopic technique after skillfully mastering.

关 键 词：肾结石 碎石术 肾造口术 经皮 内窥镜检查 手术后并发症 

分 类 号：R692.4[医药卫生—泌尿科学]