CAJ | 학술논문

目的探讨一期经皮肾镜超声碎石术治疗结石性脓肾的可行性、安全性及临床疗效.方法回顾分析23例应用经皮肾镜超声碎石术治疗结石性脓肾患者的临床资料.结果 23例均成功完成Ⅰ期手术治疗并保存肾脏,Ⅰ期清石率为78.3％(18/23 ); 2例出现术中血压急剧下降,考虑为感染性休克,改为置肾造瘘管引流,再Ⅱ期处理结石；1例术后出血严重,经保守治疗效果欠佳,行选择性肾动脉介入栓塞治愈.结论 Ⅰ期经皮肾镜超声碎石术治疗结石性脓肾是一种可行、安全、有效的方法,值得临床尝试.
목적 탐토일기경피신경초성쇄석술치료결석성농신적가행성、안전성급림상료효.방법 회고분석23례응용경피신경초성쇄석술치료결석성농신환자적림상자료.결과 23례균성공완성Ⅰ기수술치료병보존신장,Ⅰ기청석솔위78.3％(18/23 ); 2례출현술중혈압급극하강,고필위감염성휴극,개위치신조루관인류,재Ⅱ기처리결석；1례술후출혈엄중,경보수치료효과흠가,행선택성신동맥개입전새치유.결론 Ⅰ기경피신경초성쇄석술치료결석성농신시일충가행、안전、유효적방법,치득림상상시.
Objective To investigate the feasibility,safety and clinical efficacy of stage-Ⅰ percutaneous ultrasonic lithotripsy for upper urinary calculi complicated with pyonephrosis..Methods Retrospectively analyzed the clinical data on 23 patients with upper urinary calculi complicated with pyonephrosis who had undergone stage-Ⅰ percutaneous ultrasonic lithotripsy.Results The procedure was successfully performed on all the patient.No complications occurred.The stage-Ⅰ rate of stone removal was 78.3％ ( 18/23 ).Two patients had a sharp decline in blood pressure during surgery due to septic shock and they received nephrostomy drainage for phase Ⅱ process of stone.One patient was cured with selective renal artery embolization because of severe bleeding and no response to conservative treatment.Conclusions stage-Ⅰ percutaneous ultrasonic lithotripsy for upper urinary calculi complicated with pyonephrosis is feasible,safe,and effective.It is worth trying clinically.