经皮肾穿刺造瘘碎石术治疗鹿角形肾结石-陆军军医大学学报（原第三军医大学学报）

文章信息/Info

Author(s):: LI Long-kun; SONG Cai-ping; LI Wei-bing; YAN Jun-an; ZHANG Rui-qi; SONG Bo; Urinary Surgery Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China

摘要:: 目的探讨肾脏鹿角形结石的经皮肾穿刺造瘘碎石术（percutaneous nephrolithotomy, PCNL）治疗及注意事项。方法回顾总结158例行PCNL治疗，以及PCNL结合体外冲击波碎石（extracorporeal shock-wave lithoclasty, ESWL）治疗的肾脏鹿角形结石患者。结果一期PCNL清除结石64例，结合ESWL 73例，2次以上PCNL 46例，结石清除率83.5%，术中术后发生休克13例，发热9例，肉眼血尿者47例（5例患者因严重肉眼血尿而拔除双J管），耻骨上区、腰腹部不适及肾绞痛23例（4例患者经对症治疗无好转而拔除双J管）。结论 PCNL是肾鹿角型结石的有效治疗方法，术中术后应密切注意患者全身情况。

Abstract:: Objective To report the experience of percutaneous nephrolithotomy (PCNL) in the treatment of staghorn nephrolithiasis. Methods Totally 158 patients with staghorn nephrolithiasis treated by PCNL or together with extracorporeal shock-wave lithoclasty (ESWL) were retrospectively reviewed. Results Sixty-four patients were well cured with one-staged PCNL, 73 with PCNL plus ESWL, and 46 with more than two-staged PCNL. Stone clearance rate was 83.5%. The complications included shock in 13 patients, fever in 9, gross hematuria in 47, discomfort in 23, postoperative removal of double pigtail stents in 9 (5 due to serious hematuria, 4 for unendurable discomfort). Conclusion PCNL is an effective surgery for staghorn calculus, however the occurrence of shock should be paid attention to.