低压灌注超声碎石清石治疗感染性肾结石42例疗效观察  

Effects of Low Pressure Perfusion Ultrasonic Lithotripsy in the Treatment of Infectious Stones

作　　者：刘兆飞[1] 黄永斌[1] 张海涛[1] 徐向军[1] 黄金辉[1] 聂锐志 

机构地区：[1]南京中医药大学附属连云港市中医院泌尿外科,连云港222004

出　　处：《中国微创外科杂志》2017年第6期568-570,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：连云港市社会发展科技基金(SH1417)

摘　　要：目的探讨低压灌注标准通道经皮肾镜超声碎石术治疗感染性肾结石的临床效果。方法 2013年10月~2015年9月,对42例感染性肾结石术前抗感染治疗,行低压(30~50 cm H_2O)灌注经皮肾镜超声碎石清石术。11例坚硬、光滑结石,辅助气压弹道碎石,22例行点触式探针超声碎石清石,其余9例行原超声探针碎石清石。结果 40例一期成功手术,2例术后1个月二期取石。结石残留2例,行体外冲击波碎石和药物排石治愈。术中、术后未出现大出血、邻近脏器损伤及全身炎症反应综合征。术后发热6例,体温均低于38℃。随访3~24个月,平均6个月,无结石残留和复发。结论低压灌注标准通道经皮肾镜超声碎石清石术治疗感染性结石安全、高效。Objective To investigate clinical effects of percutaneous nephrostomy lithotripsy in the treatment of infectious kidney stones with low renal pelvic pressure perfusion and standard channel. Methods A total of 42 cases of renal infectious stones were given anti-infection treatments before operations and then underwent percutaneous nephrostomy lithotripsy with low renal pelvic pressure perfusion （30 -50 cm H2O ） , including 11 cases of bard or smooth stones given pneumatic ballistic lithotripsy as an auxiliary treatment, 22 cases of ultrasonic lithotripsy with point-contact probe, and other 9 cases with normal probe stone clearance. Results Surgical treatment was performed in 40 patients at one stage. Two patients with pyonephrosis were treated with two-staged surgical procedures. Residual stones were found in 2 cases and treated with extracorporeal shock wave lithotripsy and medication. There was no major bleeding, adjacent organ damage or systemic inflammatory response syndrome during and after operations. Six cases had fever after operation, and the temperatures were all below 38 Celsius degree. After a 6-month follow-up （range, 3 -24 months） , no residual stone or recurrence was found. Conclusion Percutaneous nephrostomy lithotripsy with low renal pelvic pressure perfnsion and standard channel is safe and efficient as a treatment of infectious stones.

关 键 词：感染性结石 低压灌注 超声碎石术 

分 类 号：R699.2[医药卫生—泌尿科学]