超声引导下经上盏入路经皮肾镜治疗鹿角形肾结石疗效分析

发布时间：2018-05-14 11:06

本文选题：经皮肾镜碎石术 + 上盏入路　；参考：《四川大学学报(医学版)》2017年02期

【摘要】：目的评价超声引导下经上盏入路经皮肾镜治疗鹿角形肾结石的疗效和安全性。方法回顾性分析2012年8月至2016年8月我院在超声引导下经上盏入路经皮肾镜治疗鹿角形结石357例患者的临床资料。统计分析患者手术时间、结石清除率、并发症等临床资料。结果所有患者均一期成功建立经皮肾镜通道并碎石。手术时间65~136min,平均(85±15)min;一期结石清除率83.4%(298/357),二期结石清除率87.1%(311/357);术后高热15例(4.2%),其中感染性休克2例(0.5%);术后需输血治疗8例(2.2%),其中3例超选择性肾动脉造影栓塞止血(0.8%);术后出现液气胸患者17例(4.7%),需行胸腔穿刺抽液或留置胸腔闭式引流患者3例(0.8%),无胸腹腔脏器损伤、肾盂穿孔、肾脏丢失等严重并发症,总体并发症率5.3%(19/357)。术后住院时间6~20d,平均(7.2±3.5)d。结论超声引导下经上盏入路经皮肾镜治疗鹿角形肾结石清石率高,且并发症较低。
[Abstract]:Objective to evaluate the efficacy and safety of ultrasound guided percutaneous nephroscopy in the treatment of staghorn nephrolithiasis. Methods from August 2012 to August 2016, 357 patients with staghorn calculi were treated by percutaneous nephroscopy under the guidance of ultrasound. The clinical data such as operation time, stone clearance rate and complications were analyzed statistically. Results all patients successfully established percutaneous nephroscopic channel and lithotripsy. The operative time was 65 ~ 136min (mean 85 卤15min), the primary stone clearance rate (83.4%) was 298R / 357g, the second stage calculi clearance rate was 87.1% (311 / 357m), the postoperative hyperthermia occurred in 15 cases (4.2min), among which 2 cases were septic shock (2 cases), 8 cases needed blood transfusion treatment, 3 cases underwent superselective renal artery embolization (3 cases). There were 17 patients with pneumothorax and 17 patients with pneumothorax. There were 3 cases with chest puncture and drainage or with closed drainage of thoracic cavity. There was no injury of thoracic and abdominal organs. Severe complications such as perforation of the renal pelvis, kidney loss, and the overall complication rate of 5.3% or 35 7%. The postoperative hospitalization time was 6 ~ 20 days, with an average of 7.2 卤3.5 days. Conclusion Ultrasound-guided percutaneous nephroscopy is effective in the treatment of staghorn renal calculi with low complications.
【作者单位】：四川大学华西医院泌尿外科;成都市第一人民医院泌尿外科;
【分类号】：R699.2

【参考文献】