超微经皮肾镜取石术治疗肾结石的体会  

Effect of Micro-percutaneous Nephrolithotomy on Treatment of Kidney Stones

作　　者：张赟[1] 李高飞[1] 张刚[1] 张慕淳[1] 蔡星建 

机构地区：[1]吉林大学中日联谊医院泌尿外科,吉林长春130031

出　　处：《医学与哲学（B）》2016年第8期48-50,共3页Medicine & Philosophy(B)

摘　　要：初探超微经皮肾镜取石术（SMP）治疗肾结石的安全性和临床疗效。选择2015年8月~2016年5月我院收治的肾结石患者26例,均有多次输尿管软镜和（或）体外冲击波碎石术（ESWL）治疗失败史,结石位于下盏、中盏、肾盂、肾盂合并下盏、肾盂合并输尿管上段分别为11例、1例、5例、5例、4例。结石直径平均为（1.2±0.6）cm。术后均不留置肾造瘘管及双＂J＂管。26例患者手术均成功完成,单通道24例,双通道2例,手术平均时间（47±19）min,术后第1天结石清除率为96.2%（25/26）,1例为下盏残留结石直径约0.7cm,1例术后出现发热（体温〉38℃）,术后住院时间（2.0±0.9）d。术后均未出现严重感染、尿外渗、肾周血肿等并发症。SMP治疗小于2cm的肾结石安全有效,尤其可作为ESWL及输尿管软镜术后残石的补救性治疗方法。To investigate the safety and clinical effect of super-micro percutaneous nephrolithotomy （SMP） in the treatment of kidney stones. 26 patients were admitted from August 2015 to May 2016 in our hospital for treatment of kidney stones. They all had a failure treatment of history ESWL （extracorporeal shock wave lithotripsy） and retrograde intrarenai surgery. The stones in low pole, mid pole, pelvic, pelvic-low pole, pelvic-upper ureter were found in 11, 1, 5, 5 and 4 cases, respectively. The mean stone size was （1.2 ± 0. 6）cm. None of the patients had nephrostomy tube and double J stent. All 26 patients were. successfully, 5 of whom received single-channel lithotripsy, and 3 required two nephrostomy tracts. The mean operation time was （47 ± 19）min. One day after the operation, the stone clearance rate was 96. 2% （25/26）. One case with residual stones located in lower pole was 0. 7cm. Fever （T〉38℃）occurred in 1 case. The postoperative hospital stay was （2.0±0.9）d. There were no complications such as postoperative infection, urine leakage and perirenal hematoma. SMP with a is a safe and efficacious procedure for renal stones smaller than 2 cm. It might be particularly suitable for kidney stone after previous surgical interventions.

关 键 词：肾结石 超微经皮肾镜取石术 输尿管软镜 体外冲击波碎石 

分 类 号：R691.4[医药卫生—泌尿科学]