后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石的临床疗效观察  

Observe the clinica effect of laparoscopic renal cyst unroofing combine with percutane- ous nephroscopic lithotripsy in renal cyst with renal or upper ureteral calculi patients

作　　者：邹伟波 吴伟江 梁晓宇 蔡志高 邹永锋 袁道彰 

机构地区：[1]龙川县人民医院泌尿外科,广东龙川517300

出　　处：《国际泌尿系统杂志》2015年第3期375-378,共4页International Journal of Urology and Nephrology

基　　金：2013年河源市社会发展科技计划项目（编号：2013-081）

摘　　要：目的探讨后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗。肾囊肿合并肾或输尿管上段结石的临床疗效。方法对本院收治的28例’肾囊肿合并结石患者采用后腹腔镜肾囊肿去顶术联合经皮肾穿刺碎石术治疗，分析患者术后成功率、手术时间、术中出血量、术后并发症以及对患者机体应激反应的影响。结果28例患者手术均获得成功，手术时间（108．5±11．7）min，术中出血量（95．5±43．8）mL，住院时间（6．1±3．4）d；术后患者均未出现感染、血压升高、发热、急性肾功能衰竭等并发症；随访1年未见囊肿复发。患者术后第1d体温、WBC、血糖均显著高于术前（P〈0．05），术后第3d均开始降低，体温、血糖与术前相比差异无统计学意义（P〉0．05）；而WBC仍高于术前（P〈0．05）；术后第1d、3d患者CRP、IL-6、皮质醇均显著升高，与术前相比差异具有统计学意义（P〈0．05）。结论后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石且疗效确切，能够降低手术时间和术中出血量，减轻患者经济压力，值得临床推广应用。Objectives To observe the clinica effect of laparoscopic renal cyst unroofing combine with per- cutaneous nephroscopic lithotripsy in renal cyst with renal or upper ureteral calculi patients. Methods 28 cases of renal cyst with gallstone patients treated with laparoscopic renal cyst unroofing combine with percutaneous nephro- scopic lithotripsy, after operation analysised the success rate of operation, operation time, intraoperative bleeding vol- ume, postoperative complications and the stress response. Results The operation of 28 cases of patients was suc- cessful. The operation time was （ 108.5 ± 11.7 ） min, the amount of bleeding was （95.5 ± 43.8 ） ml, and hospitaliza- tion time was （6.1 ± 3.4） d. postoperative patients are observed without complications of infection, high blood pres- sure,fever,acute renal failure;follow -up of 1 years no cyst recurrence. Patients first days after operation, WBC, temperature, blood glucose were significantly higher than those before operation（ P 〈 0.05 ）, third days after opera- tion, all were decreased, compared with before surgery, blood glucose and body temperature was no significant differ- ence（ P 〉0.05 ） ; although the WBC began to decreased, but still higher than that before operation（ P 〈 0.05 ） ; After first days,3 days in patients with CRP, IL -6, cortisol levels were significantly elevated, compared with preoper- ative differences were statistically significant（ P 〈0.05）. Conclusions Laparoscopic renal cyst unroofing com- bine with percutaneous nephroscopic in treat with renal cyst with renal or upper ureteral calculi patients have curative effect, can reduce the operation time and intraoperative hemorrhage volume, and reduce the economic pressure of pa- tients, and worthy of clinical application.

关 键 词：肾结石 肾造口术 经皮 输尿管结石 囊肿 腹腔镜检查 

分 类 号：R693.4[医药卫生—泌尿科学]