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目的评价超声引导下经上盏入路经皮肾镜治疗鹿角形肾结石的疗效和安全性。方法回顾性分析2012年8月至2016年8月我院在超声引导下经上盏入路经皮肾镜治疗鹿角形结石357例患者的临床资料。统计分析患者手术时间、结石清除率、并发症等临床资料。结果所有患者均一期成功建立经皮肾镜通道并碎石。手术时间65~136min,平均(85±15)min;一期结石清除率83.4%(298/357),二期结石清除率87.1%(311/357);术后高热15例(4.2%),其中感染性休克2例(0.5%);术后需输血治疗8例(2.2%),其中3例超选择性肾动脉造影栓塞止血(0.8%);术后出现液气胸患者17例(4.7%),需行胸腔穿刺抽液或留置胸腔闭式引流患者3例(0.8%),无胸腹腔脏器损伤、肾盂穿孔、肾脏丢失等严重并发症,总体并发症率5.3%(19/357)。术后住院时间6~20d,平均(7.2±3.5)d。结论超声引导下经上盏入路经皮肾镜治疗鹿角形肾结石清石率高,且并发症较低。
Objective To evaluate the efficacy and safety of ultrasound guided percutaneous nephrolithotomy in the treatment of antler kidney stones. Methods The clinical data of 357 cases of antlers treated by percutaneous nephrolithotomy under the guidance of ultrasound in our hospital from August 2012 to August 2016 were retrospectively analyzed. Statistical analysis of patients with surgery time, stone removal rate, complications and other clinical data. Results All patients had successful primary percutaneous nephroscopy and gravel. The operation time was 65 ~ 136min (mean, 85 ± 15min). The first stage stone clearance rate was 83.4% (298/357), the second stage stone clearance rate was 87.1% (311/357) Among them, 2 were septic shock (0.5%); 8 patients (2.2%) were required transfusion after operation, of which 3 patients underwent superselective renal artery angiography (0.8%); 17 patients (4.7% ), 3 patients (0.8%) undergoing thoracentesis or indwelling thoracic drainage, severe complications of thoracic abdominal cavity injury, peritoneal perforation and kidney loss, the overall complication rate was 5.3% (19/357) . Postoperative hospital stay 6 ~ 20d, an average of (7.2 ± 3.5) d. Conclusion Ultrasound-guided percutaneous nephrolithotomy percutaneous nephrolithotomy treatment of stone clear rate, and low complication.