复杂性肾结石外科治疗的安全性探讨  

The safety of surgical treatment for complex renal calculi

作　　者：许爱国[1] 徐冬冬[1] 高昕池 徐良杰[1] 

机构地区：[1]安徽省霍山县医院泌尿外科,237200

出　　处：《国际医药卫生导报》2013年第11期1641-1643,共3页International Medicine and Health Guidance News

摘　　要：目的讨论复杂性肾结石外科治疗的安全性。方法我院于2001年3月至2012年9月期间治疗复杂性肾结石患者30例，其中肾盂切开取石15例，肾实质切开取石7例，肾窦后实质切开取石5例，肾蒂血管阻断＋肾周冰块低温下。肾实质切开取石术3例。总结手术效果及患者手术时间、术中出血量及术后血尿时间，评价手术治疗的安全性。结果本组所有患者均顺利完成手术，术后一周患肾功能均恢复正常。所有患者无一例输血。残留结石5例，残石率16．67％。残石数5，残石直径0．3～0．5cm，均为肾盏内细小结石，结合EWSL治愈。同时，本组患者手术时间为50。120min，平均为（93±17）min；术后出血量为50～200ml，平均为（112±36）ml；术后血尿时间12～48h，平均为（28±7）h。结论复杂性肾结石的外科治疗安全性较高，临床治疗中应根据结石的位置、大小选择不同的手术方法。Objective To explore the safety of surgical treatment for complex renal calculi. Methods 30 patients with complex renal calculi who had been treated during the period of March 2001 to September 2012 were included in this study. 15 patients underwent pyelolithotomy, 7 received renal parenchyma incision for removing stones, 5 received renal sinus parenchyma incision for stone removal, and 3 received renal pedicle vascular blocking plus renal parenchyma incision for removing stones under pararenal low temperature with ice. The efficacy of the procedures, surgical duration, postoperative bleeding volume and duration of hematuria were analyzed. The safety of the procedures were assessed. Results The procedures were successfully peffromed on all patients, and kidney function returned to normal one week after surgery. No patients needed to receive blood transfusion. Residual stones occurred in five patients, with a rate of 16.67%. There were 5 residual stones with a diameter of 0.3 cm to 0.5 cm and they were small calyceal stones, which were finally treated by EWSL. The surgical duration was 50-120 min, with an average of （93 ± 17） rain; postoperative bleeding was 50 to 200 ml, with an average of （l 12 ± 36） ml; and postoperative duration of hematuria was 12 to 48 h, with an average of （28 _＋ 7） h. Conclusions Surgical treatment for complex renal calculi has higher safety. In clinical treatment, different surgical procedures should be selected accroding to the location and size of the stones.

关 键 词：复杂性肾结石 外科治疗 安全性 

分 类 号：R699[医药卫生—泌尿科学]