B超引导下超微经皮肾镜取石术治疗上尿路结石的疗效观察  

作　　者：杨金校[1] 李建华[1] 王钧钧[1] 占鹏程[1] 叶福增[1] 赵永久[1] 

机构地区：[1]杭州市萧山区第一人民医院,311201

出　　处：《浙江临床医学》2020年第2期248-249,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨超微通道经皮肾镜取石术(SMP)治疗上尿路结石的临床疗效及安全性.方法回顾性分析2017年6月至2019年2月采用B超引导下SMP治疗直径<2.5cm肾结石、输尿管上段结石38例,对手术时间、血红蛋白下降程度、住院时间、手术并发症及一期结石清除率等临床资料进行分析.结果38例均经单通道一期行超微经皮肾镜取石术.手术时间20~65min,平均(33.8±11.3)min;术后住院天数3~9d,平均(4.4±0.7)d;血红蛋白下降5~26g/L,平均(10.9±3.4)g/L.术后第1天评估结石清除率为89.5%(34/38),术后1个月评估结石清除率为94.7%(36/38).2例术后发热,1例出现肾周血肿合并发热,均予以抗炎对症治疗后治愈,其余患者无严重出血、尿外渗、血气胸、脏器损伤等并发症发生,无输血病例.结论B超引导下SMP治疗<2.5cm的上尿路结石是安全有效的,值得临床推广.Objective To evaluate the efficacy and safety of super mini-percutaneous nephrolithotomy(SMP)by ultrasound-guided for upper urinary calculi.Methods FromJune 2017 to February 2019,38 patients with upper urinary calculi(<2.5cm)underwent the SMP by ultrasound guide.The operation time,Intraoperative blood loss,length of hospital stay,complications and calculi clearance rate of the patients were analyzed after operation.Results All patients had a single channel and single stage of calculi.The operation time was 20?65min,mean(33.8土11.3)min.The average hospital stay was 3?9d,mean(4.4±0.7)d.The hemoglobin drop was 5?26g/L,mean(10.9±3.4)g/L.The calculi clearance rate after 1 day was 89.5%(34/38),The calculi clearance rate after I month was 94.7%(36/38).Fever occurred in 2 cases,fever with perirenal hematoma occurred in I case.No one needed blood transfusion.Conclusion SMP by ultrasound-guided is a safe and efficacious procedure for uncomplicated upper urinary calculi smaller than 2.5cm,and is worthy of promoting clinically.

关 键 词：超微经皮肾镜取石术 钬激光 上尿路结石 

分 类 号：R69[医药卫生—泌尿科学]