CAJ | 학술논문

目的探讨后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石的临床疗效.方法对本院收治的28例肾囊肿合并结石患者采用后腹腔镜肾囊肿去顶术联合经皮肾穿刺碎石术治疗,分析患者术后成功率、手术时间、术中出血量、术后并发症以及对患者机体应激反应的影响.结果 28例患者手术均获得成功,手术时间(108.5±11.7)min,术中出血量(95.5 ±43.8) mL,住院时间(6.1±3.4)d;术后患者均未出现感染、血压升高、发热、急性肾功能衰竭等并发症;随访1年未见囊肿复发.患者术后第1d体温、WBC、血糖均显著高于术前(P＜0.05),术后第3d均开始降低,体温、血糖与术前相比差异无统计学意义(P＞0.05);而WBC仍高于术前(P＜0.05);术后第1d、3d患者CRP、IL-6、皮质醇均显著升高,与术前相比差异具有统计学意义(P＜0.05).结论后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石且疗效确切,能够降低手术时间和术中出血量,减轻患者经济压力,值得临床推广应用.
목적 탐토후복강경신낭종거정연합경피신천자쇄석술치료신낭종합병신혹수뇨관상단결석적림상료효.방법 대본원수치적28례신낭종합병결석환자채용후복강경신낭종거정술연합경피신천자쇄석술치료,분석환자술후성공솔、수술시간、술중출혈량、술후병발증이급대환자궤체응격반응적영향.결과 28례환자수술균획득성공,수술시간(108.5±11.7)min,술중출혈량(95.5 ±43.8) mL,주원시간(6.1±3.4)d;술후환자균미출현감염、혈압승고、발열、급성신공능쇠갈등병발증;수방1년미견낭종복발.환자술후제1d체온、WBC、혈당균현저고우술전(P＜0.05),술후제3d균개시강저,체온、혈당여술전상비차이무통계학의의(P＞0.05);이WBC잉고우술전(P＜0.05);술후제1d、3d환자CRP、IL-6、피질순균현저승고,여술전상비차이구유통계학의의(P＜0.05).결론 후복강경신낭종거정연합경피신천자쇄석술치료신낭종합병신혹수뇨관상단결석차료효학절,능구강저수술시간화술중출혈량,감경환자경제압력,치득림상추엄응용.
Objectives To observe the clinica effect of laparoscopic renal cyst unroofing combine with percutaneous nephroscopic lithotripsy in renal cyst with renal or upper ureteral calculi patients.Methods 28 cases of renal cyst with gallstone patients treated with laparoscopic renal cyst unroofing combine with percutaneous nephroscopic lithotripsy,after operation analysised the success rate of operation,operation time,intraoperative bleeding volume,postoperative complications and the stress response.Results The operation of 28 cases of patients was successful.The operation time was (108.5 ± 11.7) min,the amount of bleeding was (95.5 ± 43.8) ml,and hospitalization time was (6.1 ±3.4)d.postoperative patients are observed without complications of infection,high blood pressure,fever,acute renal failure;follow-up of 1 years no cyst recurrence.Patients first days after operation,WBC,temperature,blood glucose were significantly higher than those before operation(P ＜ 0.05),third days after operation,all were decreased,compared with before surgery,blood glucose and body temperature was no significant difference(P ＞0.05);although the WBC began to decreased,but still higher than that before operation(P ＜ 0.05);After first days,3 days in patients with CRP,IL-6,cortisol levels were significantly elevated,compared with preoperative differences were statistically significant(P ＜0.05).Conclusions Laparoscopic renal cyst unroofing combine with percutaneous nephroscopic in treat with renal cyst with renal or upper ureteral calculi patients have curative effect,can reduce the operation time and intraoperative hemorrhage volume,and reduce the economic pressure of patients,and worthy of clinical application.