中国内镜杂志2017，Vol.23Issue(12)：106-110,5.DOI:10.3969/j.issn.1007-1989.2017.12.022
标准通道辅助微通道经皮肾镜取石术联合EMS治疗
鹿角形肾结石合并脓肾的经验总结
Experience of standard access assisted MPCNL combined with EMS for the treatment of staghorn calculi accompanied with pyonephrosis
阳旭明 1马子芳 1资小龙 1陶学庭 1邓钊晋 1陈日新1
作者信息
- 1. 湖南省衡阳市中心医院 泌尿外科,湖南 衡阳 421001
- 折叠
摘要
Abstract
Objective To investigate the efficacy and safety of standard access assisted minimally access percutaneous nephrolithotomy (MPCNL) combined with EMS lithotripsy system in treatment of staghorn caculi accompanied with pyonephrosis. Methods From October 2015 to May 2017, we retrospectively analyzed the clinical data of 53 patients of staghorn calculi accompanied with pyonephrosis (55 sides, 2 patients with bilateral) were treated with using the special urology ultrasound, kidney dome puncture path method method to do standard channel assisted MPCNL combined with EMS. To summarize the operation time, stone clearance rate, postoperative hospital stay, postoperative blood transfusion rate and complications. Results 53 patients had a total of 55 kidneys had been established first-staged F24 channels,and successfully gravel stone. The operation time was (82.3 ± 22.5) min; 72.7% of the renal had been established first-staged F24 channels assisted F16/18 dual channel;18.2% for the first phase F24 and secondary phase F16/18 of the dual or multi-channel; 9.1% PCNL combined with retrograde flexible ureteroscope; 4 cases of extracorporeal shock wave lithotripsy. The initial stone-free rate was 70.9% (39/55), total stone-free rate was 89.1% (49/55). 2 patients with postoperative blood transfusion, 1 case of super-selective renal artery embolization to stop bleeding, 3 patients had postoperative fever, 1 case of septic shock, 2 cases of conservative treatment of a small amount of liquid chest, 1 case of apparent low back pain due to urine extravasation, given pain medication.no other serious complications. Conclusions By special urology ultrasound probe guide, use the kidney dome puncture path method to do standard channel assisted MPCNL combined with EMS for the treatment of staghorn calculi accompanied with pyonephrosis, its benefits in high stone-free rate, low renal pelvis pressure, high security rate, low complication rate and so on. Therefore, it is worthy of clinical application.关键词
超声引导/经皮肾镜取石术/鹿角形肾结石/脓肾Key words
ultrasound guided/percutaneous nephrolithotomy/staghorn calculi/pyonephrosis分类
医药卫生引用本文复制引用
阳旭明,马子芳,资小龙,陶学庭,邓钊晋,陈日新..标准通道辅助微通道经皮肾镜取石术联合EMS治疗
鹿角形肾结石合并脓肾的经验总结[J].中国内镜杂志,2017,23(12):106-110,5.
