一期或分期mini-PCNL治疗肾盂结石伴积脓38例临床分析

发布时间：2018-06-21 06:33

本文选题：肾盂积脓 + 结石　；参考：《东南大学学报(医学版)》2015年04期

【摘要】：目的:探讨肾盂结石伴积脓患者mini-PCNL术中处理方法。方法:本研究回顾性分析了我院2006年5月至2014年12月间收治的肾盂结石伴积脓的患者共38例,年龄21~65岁,平均45岁,患者经皮肾穿刺引出脓液后17例仅行经皮肾造瘘术,两周后行二期mini-PCNL;21例患者术中充分引流脓液、应用庆大霉素生理盐水低压冲洗后一期行钬激光碎石术。结果:17例二期手术患者中,15例获得良好的治疗效果,2例有残石,再次行mini-PCNL术;术后发生全身炎症反应综合征者2例。21例一期手术者中,20例获得良好的治疗效果;1例有残石,行体外冲击波碎石;术后发生全身炎症反应综合征1例。结论:肾盂结石伴积脓miniPCNL术中行充分引流、抗生素液低压冲洗后对于合适的患者可以进行一期碎石,安全性有待临床进一步证实。
[Abstract]:Objective: to investigate the intraoperative management of mini-PCNL in patients with pyogenic pyelolithiasis. Methods: from May 2006 to December 2014, 38 patients with pyelolithiasis accompanied with pyosis were retrospectively analyzed. The mean age was 45 years (21 65 years). After percutaneous nephrostomy, 17 cases were treated with percutaneous nephrostomy. Two weeks later, 21 patients with mini-PCNLT were treated with holmium laser lithotripsy after low-pressure rinsing with gentamicin saline. Results 15 out of 17 cases of second stage operation received good therapeutic effect, 2 cases had residual stone, 2 cases had mini-PCNL, and 20 cases of 20 patients with systemic inflammatory response syndrome after operation got good curative effect, and 1 case had residual stone. Extracorporeal shock wave lithotripsy was performed and systemic inflammatory response syndrome occurred in 1 case. Conclusion: the renal pelvis stone with pyogenic miniPCNL should be well drained during operation and the antibiotic solution can be washed with low pressure for the patients with primary lithotripsy. The safety of the lithotripsy remains to be confirmed by clinical practice.
【作者单位】：南京医科大学附属江宁医院泌尿外科
【分类号】：R699.2

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