论文部分内容阅读
目的总结经12肋小切口肾窦内肾盂切开取石术的临床应用经验。方法 2005年9月～2010年12月共80例患者接受经12肋小切口肾窦内肾盂切开取石术,对手术入路、临床效果及并发症进行回顾性分析总结。结果 80例手术均获成功,未延长切口。平均手术时间92 min(60～150 min),术中平均出血量102 mL(50～210 mL),均未输血。术后36 h内均恢复进食。2例术后漏尿,分别于5 d、7 d后消失。7例有小结石残留,行体外冲击波碎石和药物排石治疗,结石排出。3例鹿角形结石患者取石时出现肾盂撕裂,借助Fr10导尿管的气囊将回缩的肾盂组织牵出以方便缝合,效果良好。输尿管支架于术后3～4周拔除,拔除后共有62例患者得到继续随访,随访时间为3个月～4年,IVP提示肾盂、输尿管无狭窄,术前肾积水都有不同程度减轻。结论经12肋小切口肾窦内肾盂切开取石术创伤小、恢复快、疗效确切、费用较低,是一种可以选择的微创手术方式。
Objective To summarize the experience of clinical application of pelvic incision and pyelolithotomy in 12 small incisions. Methods From September 2005 to December 2010, 80 patients underwent a small incision of renal pelvis with a small incision of 12 ribs for lithotomy. The surgical approaches, clinical effects and complications were retrospectively analyzed. Results 80 cases of surgery were successful, did not extend the incision. The average operation time was 92 min (60-150 min) and the mean intraoperative blood loss was 102 mL (50-210 mL). No blood transfusion was performed. After 36 h were resumed eating. 2 cases of postoperative leakage of urine, respectively, in 5 d, 7 d disappear. 7 cases of small residual stones, extracorporeal shock wave lithotripsy and drug treatment of stone row, stone discharge. 3 cases of staghorn stone patients with renal pelvis tear, with the help of Fr10 catheter balloon retraction of the pelvis to pull out to facilitate the suture, the effect is good. Ureteral stent was removed at 3 to 4 weeks after operation. A total of 62 patients were followed up for 3 months to 4 years after the removal. The IVP showed no stenosis of the renal pelvis and ureter and preoperative hydronephrosis were relieved to varying degrees. Conclusions The small incision of renal pelvis and small incision in the renal pelvis after tracheostomy with trabecular meshwork has the advantages of less trauma, faster recovery, exact curative effect and lower cost. It is an optional minimally invasive surgical approach.