摘要
Abstract
Objective To explore the application of ercutaneous nephroscopic lithotripsy in treatment of kidney stones. Methods A retrospective study was conducted in 276 patients who accepted Percutaneous nephroscopic lithotripsy since March 2007 to March 2010, by ureteral mirror using holmium laser or air pressure ballistic gravel treatment of various kidney stones, the experience was summarized and its safety and efficacy were evaluated. Results All 276 patients had success in one-time puncture, 6 patients were given double channel puncture and 24 patients underwent II period surgery. 241 patients underwent I period surgery, with the success rate of 87.32%, including 24 cases with larger residual stones or serious intraoperatie bleeding who were successfully treated by II period surgery, 11 cases of residual stones exceeding 0.5 cm in renal pelvis, medial or upper calices who accepted extracorporeal shock wave lithotripsy treatment, patients with residual stones less than 0.5 cm were orally given drug therapy. One month after percutaneous nephroscopic lithotripsy, the KUB and ultrasound were reexamined, and calculi disappeared in all cases, hydronephrosis was alleviated or disappeared. Operation time (since puncture started) was 40~240 min, and the average peri- operative time was 120 min. The blood loss was 30~400 mL, average 215 mL, and no intraoperatie blood transfusion cases. 27 cases of postoperative high fever were found, and 3 cases of positive blood germiculturem who were cured after anti- inflammatory treatment. 2 cases were found with postoperative 9 ~14 days secondary hemorrhage, and were cured by anti-inflammatory, hemostatic, continuous bladder douche treatment, no serious complications occurred. Conclusions Percutaneous nephroscopic lithotripsy for kidney stones has such advantages as minimal invasion, high success rate, less blood loss, and less complications, and is a safe and effective treatment for kidney stones. For big calculus, Percutaneous nephroscopic lithotripsy combined with holmium laser and pneumatic ballistic gravel has better effect.关键词
肾结石/经皮肾穿刺取石/钬激光和气压弹道Key words
Kidney stones/ Percutaneous nephroscopic lithotripsy/ Holmium laser and pneumatic trajectory
分类
临床医学
