中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2009年
2期
100-102
,共3页
郭丰富%邵志强%王广健%谭善峰%何相飞%刘红君%王健明%李扬%孙福广%朱文彬
郭豐富%邵誌彊%王廣健%譚善峰%何相飛%劉紅君%王健明%李颺%孫福廣%硃文彬
곽봉부%소지강%왕엄건%담선봉%하상비%류홍군%왕건명%리양%손복엄%주문빈
经皮肾镜碎石术%双侧%肾结石
經皮腎鏡碎石術%雙側%腎結石
경피신경쇄석술%쌍측%신결석
Percutaneous nephrolithotomy,bilateral%Kidney calculi
目的 探讨同期双侧经皮肾镜碎石术的安全性及疗效. 方法 双侧肾结石或输尿管上段结石48例.其中双侧肾结石26例、一侧肾结石并发对侧输尿管结石9例、双侧输尿管上段结石5例、双侧肾结石并发一侧输尿管结石8例.结石直径1.0～7.5 cm,平均2.9 cm.其中鹿角形结石28例.患者术前血红蛋白平均(126±13)g/L,伴肾功能不全13例,SCr 188～805/μmol/L,术前透析3例.采用B超引导经皮肾镜下气压弹道联合超声碎石,双侧同期治疗.分析手术时间、失血量、输血率、住院时间、结石清除率及并发症发生情况. 结果 48例96侧均一期成功建立皮肾通路,43例双侧行一期碎石,其中4例一侧行2通道碎石;5例第二侧行二期碎石.平均手术时间(105±18)min.术后患者血红蛋白较术前平均下降21 g/L,输血5例.术后平均住院时间6.5 d.一期结石清除率77.1%(37/48),总结石清除率87.5%(42/48),4例较大残余结石者辅以ESWL治疗.无严重并发症发生. 结论 同期经皮肾镜碎石术治疗双侧肾结石或输尿管上段结石安全可行,但对肾功能差、结石负荷过大者慎行.
目的 探討同期雙側經皮腎鏡碎石術的安全性及療效. 方法 雙側腎結石或輸尿管上段結石48例.其中雙側腎結石26例、一側腎結石併髮對側輸尿管結石9例、雙側輸尿管上段結石5例、雙側腎結石併髮一側輸尿管結石8例.結石直徑1.0～7.5 cm,平均2.9 cm.其中鹿角形結石28例.患者術前血紅蛋白平均(126±13)g/L,伴腎功能不全13例,SCr 188～805/μmol/L,術前透析3例.採用B超引導經皮腎鏡下氣壓彈道聯閤超聲碎石,雙側同期治療.分析手術時間、失血量、輸血率、住院時間、結石清除率及併髮癥髮生情況. 結果 48例96側均一期成功建立皮腎通路,43例雙側行一期碎石,其中4例一側行2通道碎石;5例第二側行二期碎石.平均手術時間(105±18)min.術後患者血紅蛋白較術前平均下降21 g/L,輸血5例.術後平均住院時間6.5 d.一期結石清除率77.1%(37/48),總結石清除率87.5%(42/48),4例較大殘餘結石者輔以ESWL治療.無嚴重併髮癥髮生. 結論 同期經皮腎鏡碎石術治療雙側腎結石或輸尿管上段結石安全可行,但對腎功能差、結石負荷過大者慎行.
목적 탐토동기쌍측경피신경쇄석술적안전성급료효. 방법 쌍측신결석혹수뇨관상단결석48례.기중쌍측신결석26례、일측신결석병발대측수뇨관결석9례、쌍측수뇨관상단결석5례、쌍측신결석병발일측수뇨관결석8례.결석직경1.0～7.5 cm,평균2.9 cm.기중록각형결석28례.환자술전혈홍단백평균(126±13)g/L,반신공능불전13례,SCr 188～805/μmol/L,술전투석3례.채용B초인도경피신경하기압탄도연합초성쇄석,쌍측동기치료.분석수술시간、실혈량、수혈솔、주원시간、결석청제솔급병발증발생정황. 결과 48례96측균일기성공건립피신통로,43례쌍측행일기쇄석,기중4례일측행2통도쇄석;5례제이측행이기쇄석.평균수술시간(105±18)min.술후환자혈홍단백교술전평균하강21 g/L,수혈5례.술후평균주원시간6.5 d.일기결석청제솔77.1%(37/48),총결석청제솔87.5%(42/48),4례교대잔여결석자보이ESWL치료.무엄중병발증발생. 결론 동기경피신경쇄석술치료쌍측신결석혹수뇨관상단결석안전가행,단대신공능차、결석부하과대자신행.
Objective To discuss the safety and efficacy of simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) for bilateral renal or upper ureteral calculi. Methods Forty-eight cases (26 males, 22 females, 24-57 years )who underwent SBPCNL with pneumatic and ultrasonic power for bilateral renal or upper ureteral calculi were retrospectively reviewed. Clinical data including opera-tion time, blood loss, transfusion rates, length of hospital stay, stone free rate and complications were analyzed. Results The percutaneous renal access was successfully established under ultrasonic guid-ance in all patients. The average operation time was(105±18) rain(range 80-190 min). The average drop in hemoglobin was 21 g/L (range 5-54 g/L), with 5 patients requiring blood transfusion. In 43 patients, a single stage was performed on both sides, while 5 required the second stage PCNL on one side. A single tract was adopted on both sides in 44 patients, while 4 cases of the patients required two tracts on one side. No one required two tracts on both sides or more than one stage on both sides. The stone-clearance rate was 87.5 %. The average hospital stay was 6.5 d. There was no severe complica-tion occurred. Conclusion SBPCNL might be safe and effective for bilateral renal or upper ureteral calculi for selected patients.
