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目的:分析输尿管软镜碎石术(FUL)联合经皮肾镜取石术(PCNL)治疗鹿角状肾结石的结果及并发症情况,探寻治疗鹿角状肾结石的合适方法。方法:30例鹿角状肾结石患者接受治疗,一期PCNL术中采用F20~22经皮肾通道清理大部分结石,二期手术采用FUL击碎经皮肾通道平行肾盏残留结石,必要时转二期PCNL清理残留碎石。结果:30例患者均接受联合治疗成功,术后1个月结石清除率93.3%,2例患者残留0.8~1.2cm结石位于下盏及中盏。术后3例(10%)患者发热,2例(6.7%)患者需输血2U,无其他严重并发症。结论:采用一期PCNL清除鹿角状肾结石的大部分,二期FUL处理平行肾盏残留结石,减少了新增经皮肾通道的需要及相应的并发症,并提高了结石清除率,是鹿角状肾结石治疗的安全有效方法。
Objective: To analyze the results and complications of detrusor kidney stones treated with ureteroscopic soft lithotripsy (FUL) combined with percutaneous nephrolithotomy (PCNL) and to find a suitable method for treating antler kidney stones. Methods: Thirty patients with deer horn-shaped nephrolithiasis were treated. One stage PCNL was performed with F20-22 percutaneous nephrolithotomy for most of the stones. The second stage operation was performed by FUL to crush the residual calculus of renal calyces in percutaneous renal access. Second PCNL clean residual debris. Results: All the 30 patients were successfully treated with combination therapy. The stone clearance rate was 93.3% at 1 month after operation. The residual stones with 0.8 ~ 1.2cm in 2 patients were located in the lower and middle lamps. Three patients (10%) had fever after operation, and 2 patients (6.7%) needed blood transfusion with no other serious complications. Conclusions: The first stage PCNL is used to remove most of staghorn calculi. The second stage FUL treats residual calculus in parallel calculus, which reduces the need for new percutaneous renal access and the corresponding complication and improves the rate of stone clearance. Like kidney stones treatment of safe and effective method.