CAJ | 학술논문

目的：探讨标准通道辅助微通道经皮肾镜碎石术（PCNL）治疗复杂性结石的优势及护理措施。方法回顾性分析河北大学附属医院2010年7月至2012年7月56例复杂性结石患者行标准通道辅助微通道PCNL的治疗及护理。结果本组56例患者均成功建立标准通道及微通道并一期取净结石，51例完全取净结石，结石清除率91%，残留小结石5例，行体外冲击波碎石（ESWL）治疗后结石排净。手术时间40~100 min，平均手术时间78 min。术中出血量50~200 mL，平均130 mL。住院时间5~10 d，平均住院时间7 d。术后出血、感染、双J管移位等并发症经保守治疗后痊愈。全部病例随访3~18个月，无迟发型出血、严重感染等并发症发生。结论标准通道辅助微通道经皮肾镜碎石术治疗复杂性结石，具有结石清除率高、手术时间短、术中出血少、并发症少等优点。细致周到的护理是手术成功及患者康复的重要保障。
목적：탐토표준통도보조미통도경피신경쇄석술（PCNL）치료복잡성결석적우세급호리조시。방법회고성분석하북대학부속의원2010년7월지2012년7월56례복잡성결석환자행표준통도보조미통도PCNL적치료급호리。결과본조56례환자균성공건립표준통도급미통도병일기취정결석，51례완전취정결석，결석청제솔91%，잔류소결석5례，행체외충격파쇄석（ESWL）치료후결석배정。수술시간40~100 min，평균수술시간78 min。술중출혈량50~200 mL，평균130 mL。주원시간5~10 d，평균주원시간7 d。술후출혈、감염、쌍J관이위등병발증경보수치료후전유。전부병례수방3~18개월，무지발형출혈、엄중감염등병발증발생。결론표준통도보조미통도경피신경쇄석술치료복잡성결석，구유결석청제솔고、수술시간단、술중출혈소、병발증소등우점。세치주도적호리시수술성공급환자강복적중요보장。
Objective To investigate the nursing approaches with standard-PCNL auxiliary combined with mini-PCNL in treating complicated calculi. Methods Retrospective analysis were used in 56 cases with complex calculi in our hospital from 2010 July to 2012 July treated with standard-PCNL assisted with mini-PCNL. Results Of the 56 patients , all were successfully established standard tract and mini tract and one stage procure were take on all cases , 51 cases were completely removed the stone, the stone free rate(SFR) was 91%, 5 cases of residual calculi which extracorporeal shock wave lithotripsy (ESWL) were used in 5 cases. Operative time were 40~100 min, with a average of 78 min. Intraoperative blood loss was 50~200 mL, average 130 mL. The hospital staying time were 5~10 d, the average hospitalization time was 7 d. Postoperative bleeding, infection, double J cather shifting complications recovered after conservative treatment. All patients were followed up for 3~18 months, the results indicated that there was no delayed hemorrhage, severe infection. Conclusion Our results show that there are many advantages of applying standard-PCNL combined with mini-PCNL in treating complicated calculi, with a high SFR, short operation time, less bleeding. Carefully nursing care is important to approval the success rate of operation and rehabilitation of patients.