论文部分内容阅读
鹿角形肾结石的外科治疗历来是一难题,方法不当,就有丧失肾脏的可能。现代肾脏外科是千方百计保护肾功能,避免肾切除。肾脏离体手术操作复杂,并发症多,适应症有局限性。腔内泌尿外科的发展和液电冲击波体外碎石治疗肾结石在临床上虽取得突破性进展,在国内尚难普及的情况下,开放式手术仍不失为可取的治疗方法。为寻找一种安全有效术式,通过复习文献,从1984年4月～1986年6月对六例六个非萎缩性肾脏的鹿角形与多发性结石采用肾动脉阻断、肾脏降温、原位肾实质切开取石及狭窄肾盏漏斗部扩大整形,效果满意。一.手术步骤:持续硬膜外麻醉经十二肋下腰部斜切口,游离肾脏、肾蒂和肾动脉。肘静脉缓慢注入50％葡萄糖40毫升+肌苷2克,肾动脉注射12毫升肝素美兰溶液(10毫升生理盐水含肝素300单位,美兰2毫升)。无损伤
Surgical treatment of antler kidney stones has always been a problem, improper method, there is the possibility of losing the kidneys. Modern kidney surgery is do everything possible to protect renal function, to avoid the nephrectomy. In vitro renal surgery complicated operation, complications, indications have limitations. The development of endourology and the impact of lithofluid lithotripsy in the treatment of renal stones have achieved breakthrough in clinical practice, in the country is still difficult to popularize, open surgery is still a desirable treatment. In order to find a safe and effective surgical procedure, from April 1984 to June 1986, six cases of antinocular and multiple calculi of non-atrophic kidneys were treated with renal artery occlusion, renal hypothermia, Removal of renal parenchymal stone and narrow enamel funnel Department to expand plastic surgery, with satisfactory results. One surgical procedure: continuous epidural anesthesia by twelve ribs lower oblique incision, free kidney, renal pedicle and renal artery. The cubital vein was slowly injected with 40 ml of 50% dextrose + 2 g of inosine and 12 ml of heparinized melanin into the renal artery (300 ml of 10 ml normal saline containing heparin, 2 ml of Meilan). no damage