经皮肾镜碎石术治疗复杂性肾结石合并艾滋病病毒感染患者68例  

Percutaneous nephrolithotomy for complex renal calculi complicated with HIV infection in 68 patients

作　　者：李南南 唐智旺 汪志民 陈智勇[2] LI Nannan;TANG Zhiwang;WANG Zhiming;CHEN Zhiyong(Department of Urology,Changsha First Hospital,Changsha 410005,China)

机构地区：[1]长沙市第一医院泌尿外科,长沙410005 [2]中南大学湘雅医院泌尿外科,长沙410008

出　　处：《实用医学杂志》2021年第4期463-467,共5页The Journal of Practical Medicine

基　　金：湖南省自然科学基金面上项目(编号:2020JJ4871)。

摘　　要：目的探讨经皮肾镜碎石术治疗复杂性肾结石合并艾滋病病毒(HIV)感染患者的安全性和围手术期处理。方法自2010年1月至2020年3月,我院对复杂性肾结石合并HIV感染患者共68例行经皮肾镜碎石术,对其临床资料进行回顾性分析。结果62例患者一期碎石排石,清除率为91.17%(62/68),其中1例患者二期碎石。手术时间(93.62±10.64)min,术中出血量(145.23±21.32)mL,住院时间(5.2±2.7)d,总并发症发生率17.65%(12/68)。68例HIV阳性患者术前均检查CD4+T淋巴细胞计数,术后1 d复查CD4+T淋巴细胞计数,与术前比较差异无统计学意义(P>0.05)。手术前后相关炎症指标(白细胞、血小板、CRP)等比较差异均无统计学意义(P>0.05)。结论对复杂性肾结石合并HIV感染患者行经皮肾镜碎石术,术前进行充分的免疫评估,做好围手术期准备,术中严格遵守手术操作规定和防护措施,对于医患而言,总体是安全的,可取得良好的治疗效果。Objective To explore the safety and perioperative management of percutaneous nephrolithotomy in the treatment of complex renal calculi with HIV infection.Methods From January 2010 to March 2020,68 patients with complex nephrolithiasis and HIV infection underwent percutaneous nephrolithotomy,and their clinical data were analyzed retrospectively.Results 62 patients received primary lithotripsy,with a clearance rate of 91.17%(62/68);and one of whom received secondary lithotripsy.The surgical duration was(93.62±10.64)min,the intraoperative bleeding volume was(145.23±21.32)ml,the length of hospital stay was(5.2±2.7)d,and the total complication rate was 17.65%(12/68).There was no significant difference in CD4+T lymphocyte count between pre⁃operation and one day after surgery in 68 patients(P>0.05).There were no significant differences in inflammatory indexes(leukocyte,platelet,and CRP)before and after the procedure(P>0.05).Conclusions Sufficient preoperative assessment for immune function,full preparation for perioperative period,and strict intraop⁃erative protection measure and abidance by the rules of surgical procedures can provide safety guarantee for doctors and the patients with complex nephrolithiasis and HIV infection undergoing percutaneous nephrolithotomy.Better efficacy will be achieved.

关 键 词：经皮肾镜 HIV 复杂性肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]