无管化微创经皮肾镜治疗上尿路结石.pdf

《无管化微创经皮肾镜治疗上尿路结石.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、·24·中华腔镜泌尿外科杂志(电子版)2014年8月第8卷第4期ChinJEndourol(ElectronicEdition)．August2014，Vo1．8，No．4临床研究无管化微创经皮肾镜治疗上尿路结石刘应清陶凌松罗莉莉陈弋生邹滨【摘要】目的探讨无管化微创经皮肾镜取石术(PcNL)治疗肾和输尿管上段结石的方法、效果、安全性及优势。方法在超声引导下对153例肾、输尿管上段结石患者行微创PCNL。术后不留置肾造瘘管，缝合穿刺口。其中男性99例，女陛54例，年龄16～80岁，平均(48．7+13．9)岁。左侧上尿路

2、结石63例，右侧85例，双侧5例。双侧结石同期手术。结石大小1．0～5．0cm，平均(3．1±1．2)cm。结果153例，158侧均成功建立PCNL微创通道，一期碎石，手术时间30～150min，平均(86．5_+32．9)min。144例一期结石完全清除，清除率89．5％。6例术后应用止痛药。术后住院时间3～7d，平均(5．7±O．9)d。未出现严重并发症。结论对于手术过程中出血不严重，视野清晰能保持顺利完成手术，超声检查无大结石残留，无需二次手术就可以实施无管化。无管化微创PCNL治疗。肾和输尿管上段结石安全、有效

3、，具有创伤小、疼痛轻、恢复快、住院时间短等优势。【关键词】无管化；超声弓l导；肾结石；输尿管结石；微创手术；经皮肾镜取石术TubelessminimallyinvasivepemutaneousnephrolithotomyintheIreatm~rntofupperuemm,calculiLiuYingqing；TanLingsong,LuoLiliChertYisheng,ZouBing．"DepartmentofUrology,WuhuNo．2People'sHospital,Wuhu241000，ChinaCo

4、rrespondingauthor：LiuYingqing,Email：liuyingqing688@sina．corn【Abstract】ObjeotiveToinvestigatetheclinicalvalueoftubelessminimallyinvasivepercutaneousnephrolithotomy(mPCNL)inthetreatmentofupperurinarycalculi．MethodsOnehundredandfiftythreepatientswithupperurinarycal

5、culireceivedtubelessminimallyinvasivepercutaneousnephrolithotomyundertheguidanceofultrasound．Nephrostomytubeswerenotplacedinanypatientsattheendofprocedure，andsuturedstomadirectly．Ofthetonalcases，99weremaleand54female．Theagerangedfrom16to80yearswithanaverageof(48

6、．7~13．91years．Thestonelocationwasinvolvedintheleftupperurinarytractin63cases．Another85caseswereintherightupperurinarytract．Urolithsofupperurinarytractinvolvedinbothsideswereseenin5cases，whoacceptedoperationhomeochronously．Meanstonesizewas(3．1±1．2)mmindiameter．1~

7、sultsAllthepatientswerepuncturedsuccessfullyatoneperiodandthestoneof144patientswereremovedoutthroughsingleortwopassages．Meanoperationtimewas(86．5±32．9)min．Thetotalstoneclearanceratewas89。5．Sixcasesrequiredpainkillersafteroperation．Theaveragepostoperativehospital

8、staywas(5．7±0．9)days．NoseriouscomplicationsoccurredduringoraRertheoperation．ConclusionTubelesstechnologycallbeappliedtothesepatientswhohadlessbleeding，successfulcompl