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岭南现代临床外科 ›› 2017, Vol. 17 ›› Issue (03): 368-375.DOI: 10.3969/j.issn.1009-976X.2017.03.030

• 论著与临床研究 • 上一篇    下一篇

斜卧截石联合体位经皮肾镜术治疗复杂性肾结石的临床研究

陈智林 林毅峰 何强 钟伟枫 万沛 黄志成 彭栋 陈南辉   

  1. 梅州市人民医院泌尿外四科
  • 通讯作者: 陈南辉

The supine and lithotomy position percutaneous nephrolithotomy for complex kidney stones : Clinical experience and outcome

CHEN Zhilin ,LIN Yifeng ,HE Qiang ,ZHONG Weifeng ,WAN Pei ,HUANG Zhicheng ,PENG Dong ,CHEN Nanhui.   

  1. 1 Department of Urology,Meizhou People′ s Hospital,Meizhou,Guangdong 514021,China; 2 Department of Urology,Sun Yat?sen University Cancer Center,Guangzhou 510060,China.
  • Online:2017-06-20 Published:2017-06-20
  • Contact: CHEN Nanhui

摘要:

目的 斜卧石联体位皮肾取石PCNL复杂肾结方法 及疗效。方法20126月至20165月我院107例复杂性肾结石患25例合并输尿管结采用斜卧截石联合体经超声X线引导穿刺并建立取石通道PCNL术中可同时输尿管镜逆行经膀胱输尿管进行碎将剩余结石冲入肾自经皮肾镜通道取出结结果 有患者均采用单通道完成手术操作。总体手术时间95.1±26.9min不包括穿刺定位时体结石一次手术清除率85.1%。其25例合并输尿管结石的患者结石均在首次手术中清除5例患者出现迟发性出3例患者出现严重感结论 斜卧截石联合体PCNL对于疗复杂性肾结石是一种安有效的手术体位。相比俯卧PCNL该体位能够在达到相似结清除率的同时明显降低手术时间利于术中麻醉监测

关键词: 经皮肾镜取石术, 斜卧截石体位, 复杂性肾结石

Abstract:

 Objective To investigate the method and efficacy of supine and lithotomy position in complex kidney stones treated by percutaneous nephrolithotomy. Methods From June 2012 to May 2015, 107 patients with complex kidney stones underwent percutaneous nephrolithotomy in supine and lithotomy position. The access tracts were established by ultrasound or fluoroscopic guided. Then retrograde Ureteroscopy was performed to deal with the residual stones. Results All patients had a single puncture site. The average operation time were 95.1 ± 26.9 min. The total stone?free rate after the first session was 85.1%. The ureteral stones in 25 cases were cleared in the first session. Serious delayed hemorrhage was occurred in five patients. Postoperative urinary system severe infection was found in three patients. Conclusion This modified PCNLsupine and lithotomy positionis a safe and effective approach for the treatment of complex kidney stones. Compare to classic prone position, the stone clearance and complication seem to be similar, but the operation time was confirmed to be shortened.

Key words: complex kidney stones, supine and lithotomy position, percutaneous nephrolithotomy

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