斜跨位超微通道经皮肾镜的疗效分析  

Ultra-mini percutaneous nephrolithotomy in semi-supine combined lithotomy position:an outcome analysis

作　　者：李卓航[1] 谢伟槟[1] 刘成[1] 李奎庆[1] 黄立[1] 于浩[1] 韩金利[1] 许可慰[1] Li Zhuohang;Xie Weibin;Liu Cheng;Li Kuiqing;Huang Li;Yu Hao;Han Jinli;Xu Kewei(Department of Urology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院泌尿外科,广州510120

出　　处：《中华腔镜泌尿外科杂志（电子版）》2020年第4期246-248,共3页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金资助项目(81572511、81702525);广东省基础与应用基础研究专项自由申请项目(2016A030313317);广州市科技计划项目(201803010029);逸仙临床培育项目(sys-c-201802)。

摘　　要：目的探讨斜跨位(即斜仰卧-截石位)超微通道经皮肾镜术的有效性及安全性。方法2016年4月至2017年12月共对我院96例患者施行斜跨位超微通道经皮肾镜碎石取石术。男60例,女36例,年龄25~66岁。结石长径(22±7,15~41)mm。术中将患者置于患侧斜向上45°斜跨位,逆行留置9.5/11.5 F输尿管通道鞘或7 F输尿管导管。在超声引导下进行定位穿刺,穿刺成功后逐步扩张并置入11/13 F超微通道经皮肾镜外鞘。采用200μm钬激光碎石。取石满意后,根据结石碎片清除情况、通道是否有出血决定是否留置双J管和(或)肾造瘘管。结果96例患者均顺利完成手术。平均手术时间(76±33)min。术后血红蛋白下降值(16±11)g/L。术后4例出现发热38.5~38.9℃。无其他术中术后并发症。术后平均住院时间(3.9±1.3)d。术后1个月结石清除率91.7%(88/96)。结论斜跨位下超微通道经皮肾镜术并发症少、术后恢复时间短,且结石清除率较高,值得进一步推广应用。Objective To assess the efficacy and safety of ultra-mini PCNL(UMP)in semisupine-lithotomy position.Methods During April 2016 to December 2017,UMP for 96 renal stone cases with patients positioned in 45°semisupine-lithotomy position were implemented.The patients were of 60 male and 36 female,aged 25-66 years.The mean stone size was(22±7,15–41)mm.During operation,a retrograde 9.5/11.5 F ureter access sheath or a 7 F ureteral catheter was firstly placed.The type-B sonography was used for stone locationing and 200μm holmium laser was used for lithotripsy.Results All 96 cases were successfully completed.The mean operative time was(76±33)min.Mean hemoglobin drop was(16±11)g/L.Fever 38.5-38.9℃occurred in 4 cases.No other complications occurred.The post-operative hospital stay was(3.9±1.3)days.The stone-free rate of 1 month was 91.7%(44/48).Conclusion Implementation of UMP in 45°semisupine combined lithotomy position is feasible and safe.The procedure is less invasive and has faster recovery period.

关 键 词：肾结石 超微通道 经皮肾镜 斜跨位 

分 类 号：R699.2[医药卫生—泌尿科学]