CAJ | 학술논문

目的：：提高运用微通道经皮肾镜气压弹道碎石术术治疗感染性鹿角形肾结石的能力.方法：2009年1月~2014年6月,共有73例(77侧)感染性鹿角形肾结石患者接受微通道经皮肾镜气压弹道碎石术术治疗.回顾性分析此73例患者的临床资料,统计手术时间、术后血红蛋白(Hb)下降值、术后输血率、一期结石清除率、术后发热发生率以及并发症发生情况.结果：73例(77侧)患者均成功建立一期经皮肾通道并完成一期取石手术.手术时间为51.7~212.0 min,平均(102.3±42.2)min.Hb 下降值为9~47 g/L,平均(17.3±5.4)g/L.7.8％(6/77)术后接受了输血.一期结石清除率为74.0％(57/77),结合体外冲击波碎石(ESWL)治疗一期结石清除率为81.8％(63/77).术后发热发生率为10.4％(8/77).1例患者因为输血治疗无效行超选择性肾动脉栓塞止血,1例患者发生尿脓毒症休克,无周围器官损伤发生,无死亡病例.结论：在充分掌握手术技巧、完善术前风险控制和术后管理的前提下,微通道经皮肾镜气压弹道碎石术术治疗感染性鹿角形肾结石不失为一种安全有效的方法.
목적：：제고운용미통도경피신경기압탄도쇄석술술치료감염성록각형신결석적능력.방법：2009년1월~2014년6월,공유73례(77측)감염성록각형신결석환자접수미통도경피신경기압탄도쇄석술술치료.회고성분석차73례환자적림상자료,통계수술시간、술후혈홍단백(Hb)하강치、술후수혈솔、일기결석청제솔、술후발열발생솔이급병발증발생정황.결과：73례(77측)환자균성공건립일기경피신통도병완성일기취석수술.수술시간위51.7~212.0 min,평균(102.3±42.2)min.Hb 하강치위9~47 g/L,평균(17.3±5.4)g/L.7.8％(6/77)술후접수료수혈.일기결석청제솔위74.0％(57/77),결합체외충격파쇄석(ESWL)치료일기결석청제솔위81.8％(63/77).술후발열발생솔위10.4％(8/77).1례환자인위수혈치료무효행초선택성신동맥전새지혈,1례환자발생뇨농독증휴극,무주위기관손상발생,무사망병례.결론：재충분장악수술기교、완선술전풍험공제화술후관리적전제하,미통도경피신경기압탄도쇄석술술치료감염성록각형신결석불실위일충안전유효적방법.
Objective:To improve the ability of treat infectious staghorn calculi with micro-channel percutaneous pneumatic lithotripsy.Methods:From 2009 january to 2014 june,there were 73 patients (77 sides)with infectious staghorn calculi underwent micro-channel percutaneous pneumatic lithotripsyin our hospital.We analyze the clinical data of the 73 patients retrospectively ,count the operation time,decrease of Hb,transfusion rate,one-staged stone clearance rate,incidence of postoperative fever and complications.Results:Allpercutaneous renal accesses in 73 cases (77 sides)were successfully established and the one-staged percutaneous nephrolithotomy were performed.The op-eration time of the one-staged percutaneous nephrolithotomyranged from 51.7 to 212.0 min,average (102.3±42.2) min.The decrease of Hbranged from 9 to 47 g/L,average (17.3±5.4)g/L.7.8%(6/77)operations received blood transfusion.The one-staged stone clearance rate was 74.0%(57/77)and the one-stagedclearance rate increased to 81.8% (63/77)after ESWL. Postoperative fever incidence was 10.4%(8/77).1 patient received super selective re-nal artery embolization. 1 patient had uroseptic shock,no peripheral organ damage and no deaths.Conclusions:In condition that operation skills are fully mastered,the preoperative risk is controlled and the postoperative manage-ment is improved,its a safe and effective method to treat infectious staghorn calculi with micro-channel percutaneous nephrolithotomy pneumatic lithotripsy,It is worth recommending.