[1]石磊,高振利,姜仁慧,等.经皮肾镜气压弹道联合超声碎石清石的并发症防治[J].中华腔镜泌尿外科杂志(电子版),2007,(02):76-80.
 SHI Lei,GAO Zhen-li,JIANG Ren-hui,et al.Prevention and treatment of complications of combined pneumatic and ultrasoud lithotripsy during percutaneous nephrolithotomy[J].,2007,(02):76-80.
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经皮肾镜气压弹道联合超声碎石清石的并发症防治()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2007年02期
页码:
76-80
栏目:
出版日期:
1900-01-01

文章信息/Info

Title:
Prevention and treatment of complications of combined pneumatic and ultrasoud lithotripsy during percutaneous nephrolithotomy
作者:
石磊高振利 姜仁慧王建明刘庆祚张鹏奉友刚王琳孙德康杨典东吴吉涛门昌平
青岛大学医学院附属烟台毓璜顶医院泌尿外科,烟台,264000
Author(s):
SHI LeiGAO Zhen-liJIANG Ren-huiWANG Jian-mingLIN Qing-zuoZHANG PengFENG You-gangWANG LinSUN De-kangYANG Dian-dongWU Ji-taoMEN Chang-ping
关键词:
肾结石输尿管结石肾镜气压弹道碎石并发症
摘要:
目的 探讨经皮肾镜气压弹道联合超声碎石清石的并发症防治措施.方法 本组634例,男325例,女309例.年龄6~81岁,平均44岁.KUB测量结石最大径1.5~7.2 cm,平均3.3 cm.超声波示344例545侧无肾积水,290例402侧合并肾积水,集合系统分离1.0~4.2 cm.在超声波引导下穿刺并扩张建立F14~F24经皮肾通道,在F20.8肾镜或F8/9.8输尿管肾镜下采用气压弹道联合超声组合式碎石清石系统,Ⅰ期或Ⅱ期粉碎结石并主动吸出体外.结果 Ⅰ期手术单侧结石清除时间5~260 min,平均41 min.术中失血约 20~400 ml,平均60 ml.单发输尿管上段结石及肾单发结石Ⅰ期手术单侧结石取净率98.2%;肾铸形或多发结石及肾结石合并输尿管上段结石Ⅰ期手术单侧结石取净率70.4%,总的Ⅰ期手术单侧结石取净率77.0%.无严重感染.6例(9.4‰)术后出现严重出血,1例行肾动脉超选栓塞止血后好转,4例经保守止血治疗好转,1例(1.5‰)行患肾切除.218侧肾盂、肾盏内残留结石,残留结石最大径0.2~2 cm.20侧多发的或位于肾盂的最大径>1 cm的残留结石,于Ⅰ期手术后7~10 d行Ⅱ期手术清石; 78侧术后1个月行体外冲击波碎石1~4次,28例残余结石排净,其余50例部分排石或未排石,残余结石未引起上尿路梗阻,未行进一步处理;另114侧残留结石均位于肾盏,最大径均<1 cm,未行进一步处理.术后肾功能及肾积水情况较术前改善.302例出院后获随访2~36个月,平均8.8个月,均无严重出血及感染,12例结石复发或残留结石明显增大并引起肾积水,再次行径皮肾镜取石术.结论 经皮肾镜气压弹道联合超声碎石清石术治疗肾及输尿管上段结石具有微创、高效、安全和技术难度低的特点,应重视其并发症的防治.

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更新日期/Last Update: 1900-01-01