标准单通道EMS系统治疗肾鹿角形结石的疗效分析  

Clinical analysis on treatment of kidney staghorn calculi by standard single-tract EMS

作　　者：熊海云[1] 曾小明[1] 余明主[1] 谭公祥[1] 陈亚梅[1] 

机构地区：[1]解放军第94医院泌尿外科,江西南昌330002

出　　处：《临床军医杂志》2014年第8期804-806,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨超声引导下标准单通道经皮肾镜气压弹道联合超声碎石清石(EMS)系统治疗肾鹿角形结石的临床疗效。方法回顾性分析2009年1月—2013年6月我科应用超声引导下标准单通道EMS系统治疗的30例肾鹿角形结石患者的临床资料。结果 12例(40%)尝试多次穿刺,肾盂结石梗阻解除率100%;首次结石完全清除13例(43.3%),对残留结石行体外震波碎石12例(40%),二期手术5例(16.7%)。有3例(10%)术后输血,10例(33.3%)术后短期发热,无肾切除、血气胸、腹腔脏器损伤、感染性休克等严重并发症发生。结论超声引导下标准单通道EMS系统治疗肾鹿角形结石安全有效,但穿刺难度较大,结石残留率高,感染并发症多见。Objective To evaluate the clinical outcomes of percutaneous nephrolithotomy （PCNL） with pneumatic and uhrasonic power by standard single-tract EMS under ultrasound guidance for treatment of kidney staghorn calculi. Methods Medical records of 30 patients with kidney staghorn calculi who had undergone standard single-tract EMS from January 2009 to June 2013 were retro- spectively analyzed. Results Repeated puncture attempt were noted in 12 cases （40%）. Pelvis obstruction removal amounted to 100%. Stone clearance was judged to be complete in 13 cases（43.3% ） at the end of the procedure and further treatment of residual stone consisted of extracorporeal shock wave lithotripsy （ESWL） in 12 cases （40%） and a second PCNL in 5 cases （ 16.7% ）. Postoperative blood transfusion was required in 3 cases （10%） and short-term fever occurred in 10 cases （33.3%）. Severe com- plications, such as nephrectomy, hydropneumothorax, abdominal organ injury, severe sepsis, did not occur during or after opera- tion. Conclusion Standard single-tract EMS system is effective and safe for the treatment of kidney staghorn calculi. But it has some shortcomings including difficulty in kidney puncture and relatively low stone clearance rate.

关 键 词：肾结石 经皮肾镜取石术 并发症 

分 类 号：R692.4[医药卫生—泌尿科学]