斜仰截石位多镜联合一期治疗复杂性肾结石

发布时间：2018-06-28 16:03

本文选题：斜仰截石位 + 多镜联合　；参考：《中国微创外科杂志》2017年01期

【摘要】：目的探讨斜仰截石位多镜联合一期治疗复杂性肾结石的疗效。方法 2013年1月~2015年12月105例复杂性肾结石气管插管全麻或连续硬膜外联合腰麻后,采用斜仰截石位,2组手术人员在双监视器分别监视下同时操作经皮肾镜和输尿管软镜碎石取石术。结果 105例均在斜仰截石位下顺利完成手术,术后均未出现出血和严重感染等并发症。手术时间70~120 min,平均85 min。术中出血量85~350 ml,平均120 ml。术后4~7 d复查X线或CT,肾结石一期的清石率为87.6%(92/105),输尿管结石清除率100%。7例行二期经皮肾镜取石术,4例术后配合体外冲击波碎石治疗,2例术后残余碎片直径≤3 mm未处理。92例随访2~24个月,平均8个月,情况良好,未发现有结石需要再处理。结论斜仰截石位多镜联合一期治疗复杂性肾结石清石率高,创伤小,安全有效。
[Abstract]:Objective to evaluate the efficacy of multiple endoscopy combined with oblique obliquity lithotomy in the treatment of complex renal calculi. Methods from January 2013 to December 2015, 105 patients with complicated renal calculi underwent general anesthesia or continuous epidural anesthesia combined with spinal anesthesia. Percutaneous nephrolithotomy and soft ureteral lithotripsy were performed under the surveillance of double monitors in two groups with oblique obliquity lithotripsy. Results 105 cases were successfully performed under oblique obliquity lithotomy, and no complications such as bleeding and severe infection were found after operation. The operation time was 70 ~ 120 min (mean 85 min). The blood loss during operation was 85 ~ 350 ml, with an average of 120 ml. 4 days after operation, X-ray or CTA examination showed that the primary lithotomy rate of renal calculi was 87.6% (92 / 105), the clearance rate of ureteral calculi was 100.7 cases, 4 cases were treated with extracorporeal shock wave lithotripsy and 4 cases were treated with extracorporeal shock wave lithotripsy (ESWL). 2 cases with residual debris less than 3 mm in diameter after operation. 92 cases were followed up for 2 ~ 24 months. Average 8 months, the condition is good, there is no stone need to be retreated. Conclusion the treatment of complex renal calculi with multiple endoscopy combined with oblique obliquity lithotomy is safe and effective.
【作者单位】：宁波市泌尿肾病医院泌尿外科;
【分类号】：R699.2

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