CAJ | 학술논문

目的：分析经皮肾镜气压弹道碎石术对患者肾功能影响的原因和机制,寻求预防方法。方法：回顾分析11例经皮肾镜气压弹道碎石患者资料,包括手术前后肾脏影像学(超声,MRU,IVP)及肾功能检查(ECT)的临床资料。结果：11例严重肾功能损害的患者,患肾滤过率均低于正常20％,ECT 呈低平曲张,I VP 不显像,9例重度肾积水,1例无明显积水,1例肾脏萎缩,其中7例术前存在肾盂输尿管交界部狭窄,4例术前无明显狭窄；8例再行肾盂输尿管交界部狭窄手术,3例切除肾脏。结论：经皮肾镜气压弹道碎石取石术后患者肾功能损害最重要的原因仍为肾盂输尿管交界部狭窄,需在取石术时同时手术解除输尿管梗阻,并密切定期术后随访。
목적：분석경피신경기압탄도쇄석술대환자신공능영향적원인화궤제,심구예방방법。방법：회고분석11례경피신경기압탄도쇄석환자자료,포괄수술전후신장영상학(초성,MRU,IVP)급신공능검사(ECT)적림상자료。결과：11례엄중신공능손해적환자,환신려과솔균저우정상20％,ECT 정저평곡장,I VP 불현상,9례중도신적수,1례무명현적수,1례신장위축,기중7례술전존재신우수뇨관교계부협착,4례술전무명현협착；8례재행신우수뇨관교계부협착수술,3례절제신장。결론：경피신경기압탄도쇄석취석술후환자신공능손해최중요적원인잉위신우수뇨관교계부협착,수재취석술시동시수술해제수뇨관경조,병밀절정기술후수방。
Objective:To analyze the reasons of renal dysfunction after percutaneous nephrolithoto my to prevent the complication.Methods:The clinical data of 11 cases of percutaneous nephrolithotomy were retrospectively re-viewed,includingultrasound,MRU,IVPandECTresultsbeforeandafteroperation.Results:In11cases withse-vere renal functioni mpair ment and creatinine filtration rate lower than 20 %of the nor mal ,ECTshowed flat varicose and I VP was not displayed .Nine cases had severe hydronephrosis ,one had no obvious hydronephrosis ,and one had renal atrophy.Preoperativeureteropelvicjunctionstenosis wasidentifiedin7cases.Eightcasesreceivedureteropelvic junctionstenosisoperation,andthreecases weresubjectedtoremovalofthekidney.Conclusions:The mostimpor-tant reason of postoperative renal dysfunction after percutaneous nephrolithotomyis ureteropelvic junction stenosis , whichneedslithotripsyof ureteral obstructionatthesametime,andpostoperativeregularfollow-upis necessary.