中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
3期
4-6
,共3页
二步扩张法%标准通道%经皮肾镜取石术%一期手术%感染性结石
二步擴張法%標準通道%經皮腎鏡取石術%一期手術%感染性結石
이보확장법%표준통도%경피신경취석술%일기수술%감염성결석
Two-step dilate%Standard renal access%Percutaneous nephrolithotripsy%One stage operation%Infection calculi
目的 探讨二步扩张法建立标准通道经皮肾镜取石术一期治疗感染性上尿路结石的方法和安全性.方法 回顾性分析2008年5月至2012年3月宣城中心医院泌尿外科收治的83例应用经皮肾镜取石术一期治疗感染性上尿路结石患者的临床资料.肾结石76例(鹿角形结石14例),输尿管上段结石7例,其中结石梗阻性脓肾9例.均在B超定位及引导下穿刺,运用二步扩张法建立24 F经皮肾通道,STORZ经皮肾镜下采用科医人100 W钬激光系统碎石.对其操作方法技巧、通道扩张成功率、手术时间和并发症、结石清除率等进行总结分析.结果 所有患者均成功建立24F经皮肾通道并一期碎石,二步扩张成功率为100％ (83/83)；手术时间40～130 min,平均(85±15)min;处理结石时间20 ～80 min,平均(41±11)min;术中出血量为20～210 ml,平均(107±17) ml.本研究未出现气胸、肠道损伤等严重手术并发症.2例术后出现高热(体温＞39℃),7例术后体温为38～39℃,其余病例术后体温＜38℃.术后2周复查,73例结石取净,10例结石残留,结石清除率为87.95％.结论 二步扩张法建立标准通道的经皮肾镜取石术在低压或无压力状态下引出肾集合系统感染性积液后,再行取石,具有手术时间短、清石效率高、感染率低、术后菌血症发生率低等优点,处理感染性上尿路结石安全、有效,值得推广.
目的 探討二步擴張法建立標準通道經皮腎鏡取石術一期治療感染性上尿路結石的方法和安全性.方法 迴顧性分析2008年5月至2012年3月宣城中心醫院泌尿外科收治的83例應用經皮腎鏡取石術一期治療感染性上尿路結石患者的臨床資料.腎結石76例(鹿角形結石14例),輸尿管上段結石7例,其中結石梗阻性膿腎9例.均在B超定位及引導下穿刺,運用二步擴張法建立24 F經皮腎通道,STORZ經皮腎鏡下採用科醫人100 W鈥激光繫統碎石.對其操作方法技巧、通道擴張成功率、手術時間和併髮癥、結石清除率等進行總結分析.結果 所有患者均成功建立24F經皮腎通道併一期碎石,二步擴張成功率為100％ (83/83)；手術時間40～130 min,平均(85±15)min;處理結石時間20 ～80 min,平均(41±11)min;術中齣血量為20～210 ml,平均(107±17) ml.本研究未齣現氣胸、腸道損傷等嚴重手術併髮癥.2例術後齣現高熱(體溫＞39℃),7例術後體溫為38～39℃,其餘病例術後體溫＜38℃.術後2週複查,73例結石取淨,10例結石殘留,結石清除率為87.95％.結論 二步擴張法建立標準通道的經皮腎鏡取石術在低壓或無壓力狀態下引齣腎集閤繫統感染性積液後,再行取石,具有手術時間短、清石效率高、感染率低、術後菌血癥髮生率低等優點,處理感染性上尿路結石安全、有效,值得推廣.
목적 탐토이보확장법건립표준통도경피신경취석술일기치료감염성상뇨로결석적방법화안전성.방법 회고성분석2008년5월지2012년3월선성중심의원비뇨외과수치적83례응용경피신경취석술일기치료감염성상뇨로결석환자적림상자료.신결석76례(록각형결석14례),수뇨관상단결석7례,기중결석경조성농신9례.균재B초정위급인도하천자,운용이보확장법건립24 F경피신통도,STORZ경피신경하채용과의인100 W화격광계통쇄석.대기조작방법기교、통도확장성공솔、수술시간화병발증、결석청제솔등진행총결분석.결과 소유환자균성공건립24F경피신통도병일기쇄석,이보확장성공솔위100％ (83/83)；수술시간40～130 min,평균(85±15)min;처리결석시간20 ～80 min,평균(41±11)min;술중출혈량위20～210 ml,평균(107±17) ml.본연구미출현기흉、장도손상등엄중수술병발증.2례술후출현고열(체온＞39℃),7례술후체온위38～39℃,기여병례술후체온＜38℃.술후2주복사,73례결석취정,10례결석잔류,결석청제솔위87.95％.결론 이보확장법건립표준통도적경피신경취석술재저압혹무압력상태하인출신집합계통감염성적액후,재행취석,구유수술시간단、청석효솔고、감염솔저、술후균혈증발생솔저등우점,처리감염성상뇨로결석안전、유효,치득추엄.
Objective To investigate the skills and safety of percutaneous nephrostomy with standard renal access created by two-step dilate in the one-stage treatment of upper urinary tract infection calculi.Methods From May 2008 to March 2012,83 patients with upper urinary tract infection calculi received PCNL with F24 standard renal access created by two-step dilate.The rate of calculi clearance and successful dilate,time of operation and complications were retrospectively analyzed.Results All of the 83 patients were received one-stage PCNL with F24 standard renal access.The rate of successful two-step dilate was 100％ (83/83).The time of operation was 40-130 minutes and mean time was(85 ± 15) minutes.The volume of hemorrhage during the operation was 20-210 ml and mean volume was (107 ± 17) ml.No patient showed severe complication such as pneumothorax,intestinal injury during or after the operation.Two patients suffered from fever over 39 ℃ and seven with 38-39 ℃ after operation,and the temperature of the others were below 38 ℃.In two weeks postoperation,calculi clearance was achieved in a single session in 73 cases(87.95％).Conclusions Using PCNL with F24 standard renal access created by two-step dilate to clear infection liquid under non-pressure before removing calculi under low perfusion pressure was a safe and effective method in one-stage treatment of upper urinary tract infection calculi.
