B超引导下超细经皮肾镜治疗肾结石的疗效观察  

Ultra - mini percutaneous nephrolithotomy guided by B - ultrasonography in the treatment of kidney stones

作　　者：孙忠杰[1] 伯晓宁[1] 刘政江[1] 苟举民[1] 黄明亮[1] Sun Zhongjie, Bai Xiaoning, Liu Zhengfiang, et al.(Department of Urology, the No. 404 Hospital of PLA , Weihai 264200, China)

机构地区：[1]解放军第404医院泌尿外科,山东威海264200

出　　处：《国际泌尿系统杂志》2018年第2期213-216,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨B超引导下行超细经皮肾镜取石术治疗肾结石的安全性和有效性。方法回顾性分析本院2015年6月至2017年1月期间行超细经皮。肾镜取石术的43例。肾结石患者的临床资料。其中位于肾上盏结石6例，肾中盏结石8例，肾下盏结石22例，肾盂结石7例；其中无。肾积水者12例，轻度肾积水21例，中度10例；其中ESWL或RIRS术后残留结石8例。结石总直径10～32mm，平均（17．0±7．6）mm；结石CT值303～1640HU，平均（1054．0±208．7）HU。结果43例均行单通道超细经皮肾镜取石术。手术时间25-132min，平均（63．3±19．8）rain；术后住院天数3～6d，平均（3．5±1．4）d；术后止痛药的使用率为11．6％（5／43）；术后第1天评估结石清除率为81．4％（35／43），术后1个月为93．0％（40／43）。术后均未留置肾穿刺造瘘管和双J管，没有发生严重的并发症。结论超细经皮肾镜取石术是治疗肾结石安全有效的方法，尤其适用于直径〈2．5cm肾结石，其结石清除率高，具有创伤小、并发症少、恢复快、无管化等优点，能明显提高患者的生活质量。Objective To evaluate the safety and efficacy of ultra - mini percutaneous neph- rolithotomy （UMP） guided by B - ultrasonography in the treatment of kidney stones. Methods The data of 43 patients diagnosed as kidney stones were retrospectively reviewed, who underwent the UMP from June 2015 to January 2017. There were 6 cases with renal upper calyx stones, 8 cases with renalmiddle calyx stones, 22 cases with inferior calyx stones ,7 cases with renal pelvis stones. In this cohort, no hydronephrosis in 12 cases, 21 cases of moderate hydronephrosis,10 cases of milddle hydronephro- sis, and 8 cases of residual stones after extracorporeal shock wave lithotripsy （ ESWL ）or retrograde in- tra renal surgery （RIRS） were found. The mean stone size was （ 17.0 ± 7.6 ） mm （ ranging from 10 to 32 mm）.Themean CTvaluewas（1054.0±208.7）HU（ranging from 303 to 1640 HU）. Results All patients were treated by single tract UMP. The mean operating time was 163.3 ± 19.8 ）min / ranging from 25 to 132 min）. The mean postoperative hospital stay was（ 3.5 ± 1.4） clays （ ranging from 3 to 6 days ）. The usage rate of pain medication was 11.6% （ 5/43 ）. The stone free rate was 81.4% （ 35/43 ） and 93.0% （40/43 ） on the first day and the first month after the operation, respectively. Nephrostomy tube and Double -pigtail stent were not placed at the end of operation. No serious compliclions were observed. Conclusions UMP can be a safe and effective method for the treatment of kidney stores, especially for inferior calyceal stones less than 2.5 cm. It offers high stone clearance rate, small trau- ma, fewer complications, rapid recovery, minimally invasiveness, short length of hospital stay and im- proved quality of life.

关 键 词：肾结石 肾造口术 经皮 超声检查 

分 类 号：R699.2[医药卫生—泌尿科学]