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
8期
729-731
,共3页
梁建奇%林灼怡%黄蔚山%卓梅%何仍富
樑建奇%林灼怡%黃蔚山%卓梅%何仍富
량건기%림작이%황위산%탁매%하잉부
上尿路结石%肾功能衰竭%输尿管镜取石术%微通道经皮肾镜取石术
上尿路結石%腎功能衰竭%輸尿管鏡取石術%微通道經皮腎鏡取石術
상뇨로결석%신공능쇠갈%수뇨관경취석술%미통도경피신경취석술
Upper urinary calculus%Renal failure%Ureteroscopic lithotripsy%Mini-percutaneous nephrostomy
目的：探讨微创治疗上尿路结石所致急性肾功能衰竭的临床效果。方法2012年12月～2013年8月，对30例上尿路结石致急性梗阻性肾功能衰竭先行输尿管置管或经皮肾穿刺造瘘，根据病情行输尿管镜取石术或微通道经皮肾镜取石术。结果均成功解除尿路梗阻，输尿管镜气压弹道取石术18例，结石取净率94．4％（17/18）；微通道经皮肾镜气压弹道取石术12例，结石取净率91．7％（11/12），无严重并发症发生。术后3～14 d血Cr由285～1162μmol/L 降至58～343μmol/L。术后随访1～6个月，平均3个月，肾功能恢复正常25例，5例仍有氮质血症，但肾功能明显改善。结论输尿管镜取石术或微通道经皮肾镜取石术治疗上尿路结石所致急性肾功能衰竭具有微创、安全、效果好等优点。
目的：探討微創治療上尿路結石所緻急性腎功能衰竭的臨床效果。方法2012年12月～2013年8月，對30例上尿路結石緻急性梗阻性腎功能衰竭先行輸尿管置管或經皮腎穿刺造瘺，根據病情行輸尿管鏡取石術或微通道經皮腎鏡取石術。結果均成功解除尿路梗阻，輸尿管鏡氣壓彈道取石術18例，結石取淨率94．4％（17/18）；微通道經皮腎鏡氣壓彈道取石術12例，結石取淨率91．7％（11/12），無嚴重併髮癥髮生。術後3～14 d血Cr由285～1162μmol/L 降至58～343μmol/L。術後隨訪1～6箇月，平均3箇月，腎功能恢複正常25例，5例仍有氮質血癥，但腎功能明顯改善。結論輸尿管鏡取石術或微通道經皮腎鏡取石術治療上尿路結石所緻急性腎功能衰竭具有微創、安全、效果好等優點。
목적：탐토미창치료상뇨로결석소치급성신공능쇠갈적림상효과。방법2012년12월～2013년8월，대30례상뇨로결석치급성경조성신공능쇠갈선행수뇨관치관혹경피신천자조루，근거병정행수뇨관경취석술혹미통도경피신경취석술。결과균성공해제뇨로경조，수뇨관경기압탄도취석술18례，결석취정솔94．4％（17/18）；미통도경피신경기압탄도취석술12례，결석취정솔91．7％（11/12），무엄중병발증발생。술후3～14 d혈Cr유285～1162μmol/L 강지58～343μmol/L。술후수방1～6개월，평균3개월，신공능회복정상25례，5례잉유담질혈증，단신공능명현개선。결론수뇨관경취석술혹미통도경피신경취석술치료상뇨로결석소치급성신공능쇠갈구유미창、안전、효과호등우점。
Objective-To-investigate-the-feasibility-and-clinical-effect-of-minimally-invasive-management-acute-obstructive-renal-failure-caused-by-upper-urinary-calculi-.-Methods-From-December-2012-to-August-2013,-data-of-30-patients-with-acute-obstructive-renal-failure-caused-by-upper-urinary-calculi-who-underwent-minimally-invasive-management-were-reviewed-retrospectively-.-All-the-patients-were-given-dwelling-ureteral-stent-or-percutaneous-nephrostomy-(-PCNL)-in-the-first-period,-and-then,-according-to-specific-conditions,-received-either-ureteroscopic-holmium-laser-lithotripsy-(URL)-or-mini-percutaneous-nephrostomy-(mini-PCNL).-Results-All-the-patients-were-treated-successfully-.The-stone-free-rate-of-URL-was-94.4%(17/18)-in-18-patients-with-middle-and-lower-ureteral-calculi,-and-the-stone-free-rate-of-mini-PCNL-was-91.7%-(11/12)-in-12-patients.No-ureteral-perforation-and-other-complications-were-recorded-.In-the-30-cases,-the-serum-Cr-level-decreased-from-285--1162-μmol/L-preoperatively-to-58--343μmol/L-at-3--14-days-postoperatively-.Renal-functions-recovered-to-normal-within-1-month-after-operation-in-25-cases.Different-degrees-of-azotemia-remained-within-1-month-after-operation-in-5-cases,-but-their-renal-functions-were-improved-significantly-.-Conclusion-Minimally-invasive-technique-is-a-safe-and-effective-method-for-the-treatment-of-upper-urinary-calculi-complicated-with-acute-obstructive-renal-failure-,-and-should-be-an-alternative-for-acute-obstructive-renal-failure-caused-by-upper-urinary-calculi-.
