全俯卧位经皮肾镜碎石术治疗肥胖女性肾结石患者的疗效分析  

Clinical analysis of percutaneous nephrolithotomy in total prone position for obese female patients with renal calculi

作　　者：严勇[1] 孙洵[1] 王磊[1] 李岗[1] 郑昕[1] 王亮[1] 李勇[1] 王珂[1] YAN Yong;SUN Xun;WANG Lei;LI Gang;ZHENG Xin;WANG Liang;LI Yong;WANG Ke(Department of Urology,The First People's Hospital of Kunming,Kunming 650011,China)

机构地区：[1]昆明市第一人民医院泌尿外科,云南昆明650011

出　　处：《现代泌尿外科杂志》2020年第7期622-624,共3页Journal of Modern Urology

摘　　要：目的总结28例全俯卧位经皮肾镜碎石取石术治疗女性肥胖肾结石患者的安全性及临床疗效。方法回顾性分析我科2017年1月至2019年9月采用全俯卧位经皮肾镜碎石术治疗28例女性肥胖肾结石患者的临床资料。患者体重均超过75 kg,体质指数(BMI)30.42±1.45,结石直径(17.6±2.7)mm,其中鹿角型结石3例。手术采用全俯卧位两腿张开输尿管镜输尿管逆行插管,成功后不用改变体位即可行经皮肾镜碎石取石术。结果本组患者均顺利完成俯卧位输尿管镜输尿管逆行插管,手术时间(61.6±27.5)min,失血量(45.6±12.4)mL,结石取净率92.9%。术中采用双通道碎石3例。术后发热2例,残留结石行二期碎石2例,术后平均住院时间(4.6±1.5)d。所有患者均未输血、未出现内脏损伤等并发症。结论全俯卧位经皮肾镜碎石术治疗女性肥胖肾结石患者,具有省时省力、疗效高、安全可靠、术后并发症发生率低、结石取净率高等优点,值得临床推广。Objective To investigate the safety and clinical efficacy of percutaneous nephrolithotomy(PCNL)in total prone position in the treatment of obese female patients with renal calculi.Methods Clinical data of 28 obese female patients with renal calculi treated with PCNL in total prone position during Jan.2017 and Sep.2019 were retrospectively analyzed.All patients weighed more than 75 kg,and the body mass index(BMI)was(30.42±1.45)kg/m^2.Staghorn stones were detected in 3 patients.All patients adopted total prone position.After the catheter was inserted retrogradely,patients remained the same position and PCNL was performed.Results All operations were successful.The operation time was(61.6±27.5)min,blood loss was(45.6±12.4)mL,and stone clearance rate was 92.9%.Double channels were established in 3 cases.Postoperative fever occurred in 2 cases.Residual stones were observed in 2 cases,who then received a second PCNL.The average postoperative hospital stay was(4.6±1.5)days.No patients required blood transfusion or suffered visceral injury.Conclusion PCNL in total prone position for obese female patients with renal calculi is safe,effective,time-saving and labor-saving,with advantages of low incidence of postoperative complications and high stone removal rate.It is worthy of clinical promotion.

关 键 词：经皮肾镜碎石取石术 俯卧位 肥胖 肾结石 疗效 

分 类 号：R692.4[医药卫生—泌尿科学]