CAJ | 학술논문

目的：探讨经皮肾镜取石术（PCNL）治疗上尿路结石治疗体会。方法：回顾性分析行B超引导下PCNL治疗上尿路结石90例患者的临床资料。结果：手术时间40～110min，平均（70.5±8.3）min。Ⅰ期手术86例，Ⅱ期手术4例。失血量与手术时间、穿刺路径呈正相关，与肾积水程度呈负相关。术后15例出现不同程度的发热，抗感染治疗后，均恢复正常。8例术后出现出血，予以夹闭肾造瘘管、止血剂、输血等治疗，7例获得成功，其中1例出血严重，行开放患肾切除。所有患者术中均无胸膜、肠管及肾邻近脏器损伤。结论：PCNL治疗上尿路结石安全有效，值得在临床上推广。
목적：탐토경피신경취석술（PCNL）치료상뇨로결석치료체회。방법：회고성분석행B초인도하PCNL치료상뇨로결석90례환자적림상자료。결과：수술시간40～110min，평균（70.5±8.3）min。Ⅰ기수술86례，Ⅱ기수술4례。실혈량여수술시간、천자로경정정상관，여신적수정도정부상관。술후15례출현불동정도적발열，항감염치료후，균회복정상。8례술후출현출혈，여이협폐신조루관、지혈제、수혈등치료，7례획득성공，기중1례출혈엄중，행개방환신절제。소유환자술중균무흉막、장관급신린근장기손상。결론：PCNL치료상뇨로결석안전유효，치득재림상상추엄。
Objective:To explore the experience of percutaneous nephrolithotomy in the treatment of 90 cases with upper urinary tract stones. Methods:The clinical data of 90 cases with upper urinary tract stones by ultra-sound-guided PCNL were retrospectively analyzed in hospital. Results:The operation time was 40~110min, and the average time was (70.5±8.3)min. 86 cases were completed in stageⅠ, and 4 cases were completed in stageⅡ. The results of multiple linear regression analysis showed that the amount of blood loss was positively correlated with operative time, and was negatively correlated with the degree of hydronephrosis.15 patients with varying degrees of fever returned to normal state via symptomatic treatment anti-infection treatment. 8 patients had hemorrhage after surgery. Among them, 7 patients were cured via conservative therapy and 1 patient who had severe hemorrhage undergone nephrectomy. All patients had no pleural, bowel and kidney adjacent organs damage. Conclusion:PCNL is a safe and effective means in the treatment of upper urinary tract stones, so it is worth being promoted in clinic.