中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2014年
5期
434-435,449
,共3页
肾结石%经皮肾镜取石术%无管
腎結石%經皮腎鏡取石術%無管
신결석%경피신경취석술%무관
Renal calculi%Percutaneous nephrolithotomy%Tubeless
目的：探讨无管化的微创经皮肾镜取石术治疗肾结石的安全性和可行性。方法2012年1月～2013年10月，对符合筛选条件的60例肾结石行一期无管化微创经皮肾镜下钬激光及气压弹道碎石取石术。在超声引导下经皮肾穿刺和通道扩张，建立F18～F24的通道，取石后常规留置双J管及导尿管。结果60例均手术成功，F1835例，F2425例，手术时间30～90 min，（48．5±2．3）min，无输血，无邻近脏器损伤。结石清除率96．7％（58/60），2例结石残留（术后2周B超提示结石直径分别为3．7、3．5 mm）。术后体温均＜39℃，无明显尿外渗。术后需要镇痛药物1例。术后留置导尿管3～5 d。术后住院5～6d。结论经严格选择的肾结石患者，无管化的微创经皮肾镜取石术效果满意，安全，术后恢复快，疼痛轻。
目的：探討無管化的微創經皮腎鏡取石術治療腎結石的安全性和可行性。方法2012年1月～2013年10月，對符閤篩選條件的60例腎結石行一期無管化微創經皮腎鏡下鈥激光及氣壓彈道碎石取石術。在超聲引導下經皮腎穿刺和通道擴張，建立F18～F24的通道，取石後常規留置雙J管及導尿管。結果60例均手術成功，F1835例，F2425例，手術時間30～90 min，（48．5±2．3）min，無輸血，無鄰近髒器損傷。結石清除率96．7％（58/60），2例結石殘留（術後2週B超提示結石直徑分彆為3．7、3．5 mm）。術後體溫均＜39℃，無明顯尿外滲。術後需要鎮痛藥物1例。術後留置導尿管3～5 d。術後住院5～6d。結論經嚴格選擇的腎結石患者，無管化的微創經皮腎鏡取石術效果滿意，安全，術後恢複快，疼痛輕。
목적：탐토무관화적미창경피신경취석술치료신결석적안전성화가행성。방법2012년1월～2013년10월，대부합사선조건적60례신결석행일기무관화미창경피신경하화격광급기압탄도쇄석취석술。재초성인도하경피신천자화통도확장，건립F18～F24적통도，취석후상규류치쌍J관급도뇨관。결과60례균수술성공，F1835례，F2425례，수술시간30～90 min，（48．5±2．3）min，무수혈，무린근장기손상。결석청제솔96．7％（58/60），2례결석잔류（술후2주B초제시결석직경분별위3．7、3．5 mm）。술후체온균＜39℃，무명현뇨외삼。술후수요진통약물1례。술후류치도뇨관3～5 d。술후주원5～6d。결론경엄격선택적신결석환자，무관화적미창경피신경취석술효과만의，안전，술후회복쾌，동통경。
Objective To explore and evaluate the feasibility and safety of tubeless mini-percutaneous nephrolithotomy for renal calculi. Methods From January 2012 to October 2013, 60 eligible cases of renal calculi received a one-stage minimally invasive percutaneous nephrolithotomy using pneumatic lithotripsy and Holmium laser .Percutaneous renal puncture and tract dilation were performed under ultrasound to establish F 18 -F24 tract, followed by postoperative conventional double-J tube and catheter indwelling. Results All the 60 operations were successful, with an operative time of 30-90 min, (average, 48.5 ±2.3 min). During the operations, no blood transfusion or adjacent organ injury occurred .Stone clearance rate was 96.7%(58/60).Ultrasound examination showed a residual stone (3.7 and 3.5 mm in diameter, respectively) in 2 patients 2 weeks after the surgery.The postoperative temperature of all patients was below 39 ℃, with no significant postoperative urine extravasation .One patient required postoperative analgesic drugs .The catheter was retained for 3 -5 d postoperatively , and postoperative hospital stay was 5 -6 d. Conclusion With strict selective procedure for the patients , tubeless mini-percutaneous nephrolithotomy is safe and effective in the treatment of renal calculi with the advantage of rapid postoperative recovery and less pain .
