无管化微通道经皮肾取石术治疗肾结石.pdf

《无管化微通道经皮肾取石术治疗肾结石.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、·434·中国微创外科杂志2014年5月第14卷；5翅坚!：!：：!：临床论著·无管化微通道经皮肾取石术治疗肾结石姚成唐智旺汪志民(长沙市第一医院泌尿外科，长沙410005)【摘要】目的探讨无管化的微创经皮肾镜取石术治疗肾结石的安全性和可行性。方法2012年1月～2013年10．月，对符合筛选条件的60例肾结石行一期无管化微创经皮肾镜下钬激光及气压弹道碎石取石术。在超声引导下经皮肾穿刺和通道扩张，建立F，～F：的通道，取石后常规留置双J管及导尿管。结果60例均手术成功，F35例，F：25例，手术时间3O90min，(48．54-2．3)min，无输血，无邻

2、近脏器损伤。结石清除率96．7％(58／60)，2例结石残留(术后2周B超提示结石直径分别为3．7、3．5mm)。术后体温均<39℃，无明显尿外渗。术后需要镇痛药物1例。术后留置导尿管3—5d。术后住院5～6d。结论经严格选择的肾结石患者，无管化的微创经皮肾镜取石术效果满意，安全，术后恢复快，疼痛轻。【关键词】肾结石；经皮肾镜取石术；无管中图分类号：R692．4文献标识：A文章编号：1009—6604(2014)05—0434一O3doi：10．3969／j．issn．1009—6604．2014．05．015TubelessMini·percutaneo

3、usNephrolithotomyforRenalCalculiYaoChengTangZhiwang，WangZhimin．DepartmentofUrology，TheFristHospitalofChangsha，Changsha410005，China【Abstract】0bjectiveToexploreandevaluatethefeasibilityandsafetyoftubelessmini-percutaneousnepbrolithotomyforrenalcalculi．MethodsFromJanuary2012toOctober

4、2013，60eligiblecasesofrenalcalculireceivedaone-stageminimallyinvasivepercutaneousnephro1ithot0myusingpneumaticlithotripsyandHolmiumlaser，PercutaneousrenalpunctureandtractdilationwereperformedunderultrasoundtoestablishF18一F24tract，followedbypostoperativeconventionaldouble—Jtubeandc

5、atheterindwelling．ResultsAllthe60operationsweresuccessful，withanoperativetimeof30—90min，(average，48．5±2．3min)．Duringtheoperations，nobloodtransfusionoradjacentorganinjuryoccurred．Stoneclearanceratewas96．7％(58／60)．Ultrasoundexaminationshowedaresidualstone(3．7and3．5mmindiameter，respe

6、ctively)in2patients2weeksafterthesurgery．Thepostoperativetemperatureofal1patientswasbelow39℃．withnosignificantpostoperativeurineextravasation．Onepatientrequiredpostoperativeanalgesicdrugs．Thecatheterwasretainedfor3—5dpostoperatively，andpostoperativehospitalstaywas5—6d．ConclusionWi

7、thstrictselectiveprocedureforthepatients，tubelessmini-percutaneousnephr0lith0t0myissafeandeffectiveinthetreatmentofrenalcalculiwiththeadvantageofrapidpostoperativerecoveryandlesspain．【KeyWords】Renalcalculi；Percutaneousnephrolithotomy；Tubeless经皮肾镜取石术(percutaneousnephrolithotomy，无管化

8、(tubeless)PCNL，即PCNL术后有选择性地PCNL)是