中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2011年
1期
11-13
,共3页
潘铁军%张加桥%李功成%文瀚东%沈国球%涂忠%杨家荣%郭骏%钱卫红
潘鐵軍%張加橋%李功成%文瀚東%瀋國毬%塗忠%楊傢榮%郭駿%錢衛紅
반철군%장가교%리공성%문한동%침국구%도충%양가영%곽준%전위홍
肾造口术,经皮%肾结石%仰卧位%输尿管结石
腎造口術,經皮%腎結石%仰臥位%輸尿管結石
신조구술,경피%신결석%앙와위%수뇨관결석
Nephrostomy,percutaneous%Kidney calculi%Supine position%Ureteral calculi
目的 研究腰肋悬空仰卧位下PCNL治疗肾和输尿管上段结石的安全性及有效性.方法2010年3-10月采用腰肋悬空仰卧位PCNL治疗泌尿系结石患者173例.平均年龄(50±11)岁.结石位于左侧70例,右侧97例,双侧6例.肾结石166例,输尿管上段结石7例.结石最大径1.5～6.0 cm,平均(2.9±1.0)cm.该体位将患侧肩部及臀部分别用3 L水袋或气囊垫高,使患侧腰肋部悬空,同时建立腰桥.均采用椎管麻醉,B超引导下穿刺肾盂或目标肾盏成功后,依次扩张通道至16 F或20 F,用钬激光或EMS碎石清石系统碎石. 结果 173例均穿刺成功并能良好耐受手术,患者无因体位不适终止手术者.平均手术时间(86±34)min.一次性结石清除率为80.3%(139/173),残留结石34例,其中行二期手术取净结石16例.术后输血治疗1例;无胸膜、腹腔脏器损伤等并发症发生. 结论腰肋悬空仰卧位下PCNL安全有效,患者耐受性好.
目的 研究腰肋懸空仰臥位下PCNL治療腎和輸尿管上段結石的安全性及有效性.方法2010年3-10月採用腰肋懸空仰臥位PCNL治療泌尿繫結石患者173例.平均年齡(50±11)歲.結石位于左側70例,右側97例,雙側6例.腎結石166例,輸尿管上段結石7例.結石最大徑1.5～6.0 cm,平均(2.9±1.0)cm.該體位將患側肩部及臀部分彆用3 L水袋或氣囊墊高,使患側腰肋部懸空,同時建立腰橋.均採用椎管痳醉,B超引導下穿刺腎盂或目標腎盞成功後,依次擴張通道至16 F或20 F,用鈥激光或EMS碎石清石繫統碎石. 結果 173例均穿刺成功併能良好耐受手術,患者無因體位不適終止手術者.平均手術時間(86±34)min.一次性結石清除率為80.3%(139/173),殘留結石34例,其中行二期手術取淨結石16例.術後輸血治療1例;無胸膜、腹腔髒器損傷等併髮癥髮生. 結論腰肋懸空仰臥位下PCNL安全有效,患者耐受性好.
목적 연구요륵현공앙와위하PCNL치료신화수뇨관상단결석적안전성급유효성.방법2010년3-10월채용요륵현공앙와위PCNL치료비뇨계결석환자173례.평균년령(50±11)세.결석위우좌측70례,우측97례,쌍측6례.신결석166례,수뇨관상단결석7례.결석최대경1.5～6.0 cm,평균(2.9±1.0)cm.해체위장환측견부급둔부분별용3 L수대혹기낭점고,사환측요륵부현공,동시건립요교.균채용추관마취,B초인도하천자신우혹목표신잔성공후,의차확장통도지16 F혹20 F,용화격광혹EMS쇄석청석계통쇄석. 결과 173례균천자성공병능량호내수수술,환자무인체위불괄종지수술자.평균수술시간(86±34)min.일차성결석청제솔위80.3%(139/173),잔류결석34례,기중행이기수술취정결석16례.술후수혈치료1례;무흉막、복강장기손상등병발증발생. 결론요륵현공앙와위하PCNL안전유효,환자내수성호.
Objective To investigate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in a new operative position, flank suspended supine position. Methods The new position hold affected flank suspended by raising the ipsilateral shoulder and haunch with two 3-liter saline bags, and set up waist bridge simultaneously. From March 2010 to October 2010, a series of 173 patients underwent PCNL with the new supine position under epidural anesthesia. The average age was (50± 11) years, and the average bulk of the stone was (2. 9±1.0) cm. All patients were placed in the new supine position. Under ultrasound guidance, the desired calix or pelvis was punctured near the posterior axillary line, then dilating the tract and establishing the 16 F or 20 F tract for PCNL. Results The pelvicaliceal system could be successfully approached in all patients. The procedure was well tolerated in all patients. Mean operation time was (86 ± 34) min. 80. 3% of the patients were rendered free of stones by the initial PCNL. Thirty-four cases had residual stones, and a second PCNL was performed in 16 cases to clear the residual stones. Only 1 patient required blood transfusion.None of the patients suffered visceral injury. Conclusion The new supine position is safe and effective for PCNL.
