单中心微通道经皮肾镜取石术治疗上尿路结石377例报道  

Outcomes of minimally invasive percutaneous nephrolithotomy in 377 cases of upper urinary calculi:a single center experience

作　　者：王亚佟[1] 夏勇[1] 张战宏[1] 拓志勇 邵林海[1] 兰海河 汪洋[1] 赵超群[1] 胡新红[1] 王叶松[1] 朱元宏 白杨开 肖怡 WANG Yatong;XIA Yong;ZHANG Zhanhong;TUO Zhiyong;SHAO Linhai;LAN Haihe;WANG Yang;ZHAO Chaoqun;HU Xinhong;WANG Yesong;ZHU Yuanhong;BAI Yangkai;Xiao Yi(Department of Urology,Hanzhong Central Hospital,Hanzhong 723000;Hanzhong Second People's Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院泌尿外科,陕西汉中723000 [2]汉中市第二人民医院,陕西汉中723000

出　　处：《现代泌尿外科杂志》2021年第7期601-604,共4页Journal of Modern Urology

摘　　要：目的分析陕西省汉中地区微通道经皮肾镜取石术(MPCNL)治疗上尿路结石的治疗现状。方法回顾性分析2019年1月至2020年12月在汉中市中心医院泌尿外科行MPCNL治疗的337例上尿路结石患者的临床资料。结果本组377例患者共实施MPCNL 479次。手术结石清除率:Ⅰ期59.68%(225/377),Ⅱ期58.70%(54/92),Ⅲ期20%(1/5)。所有患者中联合输尿管镜或输尿管软镜辅助治疗34例,其中28例取净石,结石清除率82.35%。术后84例(22.28%)患者出现感染性并发症,其中术后发热51例(13.53%)、全身炎症反应综合征(SIRS)25例(6.63%)、感染性休克8例(2.12%);同时,术中或术后输血3例(0.80%),均保守治疗后好转,未出现周围脏器损伤(如肠道、气胸)等副损伤。结论微通道经皮肾镜取石术是处理上尿路结石的一种重要手段,诊疗过程中不仅要严格按照规范操作,还要总结经验并掌握重点,从而提高疗效、降低并发症。Objective To analyze the outcomes of minimally invasive percutaneous nephrolithotomy(MPCNL)in Hanzhong District.Methods The clinical data of 377 patients with upper urinary calculi who underwent MPCNL in our hospital during Jan.2019 and Dec.2020 were retrospectively analyzed.Results MPCNL was performed for 479 times on these patients.The fist-stage,second-stage and third-stage stone-clearance rate were 59.68%(225/280),58.70%(54/92),and 20.00%(1/5),respectively.In all patients,34 received MPCNL combined with ureteroscopy or flexible ureteroscopy,and 28 were stone free,the stone-free rate being 82.35%.Complications were observed in 84 cases(22.28%),including fever in 51 cases(13.53%),SIRS in 25 cases(6.63%),infection shock in 8 cases(2.12%).Blood transfusion was performed in 3 cases(0.80%),which recovered after conservative treatment without collateral injury.Conclusions MPCNL is an important treatment for upper urinary calculi.In the process of diagnosis and treatment,we should not only strictly follow the standard operation,but also summarize the key points,so as to improve the efficacy and reduce the complications.

关 键 词：微通道经皮肾镜取石术 上尿路结石 感染性并发症 

分 类 号：R692.4[医药卫生—泌尿科学]