无管化30F通道经皮肾镜术治疗肾结石99例报告  

Tubeless 30 F tract PCNL in the treatment of renal stones in Chinese patients: initial reports of 99 cases

作　　者：雷华[1] 刘相富[2] 王德娟[1] 黄文涛[1] 肖恒军[1] 邱剑光[1] 

机构地区：[1]中山大学附属第三医院泌尿外科,广州510630 [2]中山大学附属第三医院输血科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2012年第6期4-7,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：广东省科技计划社会发展项目(2010B031600083)

摘　　要：目的探讨国内肾结石患者无管化30F通道经皮肾镜术的可行性和临床疗效。方法回顾性分析2009年11月至2011年10月我组所行的30F通道经皮肾镜术患者的围手术期资料。对于术前无脓肾、术中无肾盂穿孔者采用无管化处理,术毕不予留置肾造瘘管。结果共99例患者接受30F通道经皮肾镜术。手术时间114.46±56.52min,出血量28.54±15.54g/L,一期结石取净率78.79%(78/99),输血率22.22﹪(22/99);术后发热(T>38.5°C)10例,经抗生素治疗1～2d后体温降至正常;肾周血肿6例,经内科治疗后复查超声血肿消失或明显缩小;尿漏3例,其中2例予及时更换敷料处理2d后自愈,另1例经重置双J管后痊愈;需介入栓塞止血者4例;术后住院天数3～21d,平均7d。结论对国内肾结石患者,若术前无脓肾、术中未见肾内严重感染、无肾盂穿孔者,行无管化30F通道经皮肾镜术是可行的。Objective To assess the feasibility and efficacy of tubeless 30 F tract percutaneous nephrolithotomy （PCNL） in the treatment of renal stones in Chinese patients. Methods All consecutive 30 F tract PCNLs performed during November 2009 and October 2011 in our department were retrospectively analyzed. Tubeless 30 F tract PCNL was performed when serious renal infection and pelvic perforation were excluded. Results Ninty-nine cases of renal stones were treated with tubeless 30 F tract PCNL. The average operation time was 114.46±56.52 min, mean hemoglobin drop was 28.54±15.54 g/L, the stone-free rate of the first session was 78.79% （78/99）, and the transfusion rate was 22.22% （22/99）. Ten patients got fever postoperatively （T〉38.5℃）. Perirenal hematoma was found in 6 cases, and urine leakage in 3 cases. Angiography and embolization was performed in 4 patients. The average postoperative hospital stay was 7 days. Conclusion Tubeless 30 F tract PCNL can be a feasible way for renal stone treatment in Chinese patients when serious renal infection and pelvic perforation were excluded.

关 键 词：肾结石 经皮肾镜 无管化 

分 类 号：R699[医药卫生—泌尿科学]