超微经皮肾镜治疗上尿路结石的体会（附30例报告）  

Experience of treating urethral stone with super-mini percutaneous nephrolithotomy （30 cases report）

作　　者：朱武安[1] 张刚[1] 张慕淳[1] 蔡星建 张茁[1] 张赟[1] 范李[1] 李高飞[1] 张德华[1] 赵志易 Zhu Wuan, Zhang Gang, Zhang Muchun, et al.(Department of Urology, Sino Japanese Friendship Hospital of Jilin University ,Jilin 130033, China)

机构地区：[1]吉林吉林大学中日联谊医院泌尿外科,吉林130033 [2]宝鸡宝鸡市中心医院泌尿外科,陕西721008

出　　处：《国际泌尿系统杂志》2018年第5期733-736,共4页International Journal of Urology and Nephrology

摘　　要：目的 探讨超微经皮肾镜（sumer-mini-PCNL,SMP）治疗肾和输尿管上段结石的临床疗效及安全性.方法 回顾性分析2016年1月至2016年9月在本院行超微经皮肾镜治疗的上尿路结石30例患者的临床资料.手术结束时退出肾镜,观察通道出血情况,并结合术中结石处理情况,以决定是否留置肾造瘘管及双J管.结果 30例患者手术均顺利完成,手术时间40～ 62 min,平均48 min,术中出血30 ～ 85 mL,平均50 mL.30例患者均未留置肾造瘘管,25例未留置双J管,5例有小结石碎片残留,留置双J管.术后第一天复查腹部KUB,结石清除率（stone-free rate,SFR） 90％（27/30）,3例残留小结石,约2～3 mm,但均已留置双J管,予以口服排石药物1个月,复查泌尿CT未见任何结石,SFR达100％.4例术后出现发热,抗炎对症治疗缓解.30例患者均术后2～4d出院,平均2.5d,并随访1个月,术中、术后无严重并发症发生.结论 超微经皮肾镜治疗2 cm以内的上尿路结石是一种安全、有效且能够缩短住院时间的手术方式,临床上可适当选择. Objective To investigate the clinical efficacy and safety of sumer-mini-PCNL （SMP） in treatment of renal and upper ureteral calculi.Methods Retrospective analysis was given on 30 patients with upper urinary tract calculi hospitalized during the period from January 2016 to September 2016 in the China-Japan union hospital of Jilin university.Twenty-two male and 8 female cases,aged between 30-55 years old with an average of 45 years old.Twenty-four cases were single kidney stones and 6 cases were of upper ureteral calculi.The stone diameter was between 0.9-2.0 cm,with an average of about 1.5 cm.The renal mirror was removed,and the bleeding situation was observed at the end of the operation.And in consideration of intraoperative stone treatment to decide whether or not to adhere to the renal fistula and double-J tube.Results Thirty patients were successfully completed operation,with an average time of 40-62 min,an average of 48 min.Intraoperative bleeding was 30-85 mL,with an average of 50 mL.Thirty cases did not leave fistula,25 cases without double-J tube,and 5 cases were indwelling double-J tube due to without exception some small pieces of stone displacement in the survey.The abdomen KUB was conducted on the first day after survey,stone-free rate （SFR） was 90% （27/30）,and 3 cases were of residual stones,which have been retained double-J tube,and with oral row of stone drugs 1 month.Reviewing with urinary CT,SFR was 100%.Four cases were of postoperative fever,and were relieved by anti-inflammatory symptomatic treatment.Thirty patients were discharged 2-4 days after surgery and with follow up of 1 month,and no serious serious complications in intraoperative and postoperative was observed.Conclusions SMP is a safe and effective surgical approach,which can also short the hospital stay for the treatment of upper urinary tract calculi within 2 cm.And it can be chosen as an appropriate operation in clinics.

关 键 词：尿路结石 肾造口术 经皮 

分 类 号：R699[医药卫生—泌尿科学]