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目的:探讨微创经皮肾镜取石术(PCNL)并发腹腔脏器损伤的处理方法及疗效。方法:对肇庆市第二人民医院泌尿外科自2001年2月至2017年2月行PCNL治疗上尿路结石患者6917例中出现腹腔脏器损伤的8例患者资料进行回顾性分析,治疗上给予禁食、肠外营养支持、抗感染及加强引流等处理,并对治疗方法及疗效进行分析总结。结果:8例患者经治疗后均痊愈出院,无开放手术处理病例,平均住院天数(27±1.8)d。结论:PCNL可并发腹腔脏器损伤,多采用内科治疗为主,术前应做好相关损伤风险的评估,出现腹腔脏器损伤后,需及早做出诊断,必要时可行腹腔镜探查,除按腹腔脏器损伤的治疗原则进行处理,还应掌握造瘘管拔除时机及相关引流方法。
Objective: To explore the treatment and efficacy of minimally invasive percutaneous nephrolithotomy (PCNL) complicated with abdominal viscera injury. Methods: The data of 8 patients with abdominal organ injury in 6917 cases of upper urinary tract calculi treated with PCNL from February 2001 to February 2017 in Zhaoqing Urology Department were analyzed retrospectively. Fasting, parenteral nutrition support, anti-infection and strengthening drainage and other treatment, and analysis of treatment methods and efficacy summary. Results: All 8 patients were cured after treatment. There was no open surgery and the average length of stay was (27 ± 1.8) days. Conclusion: PCNL can be complicated by abdominal viscera injury, and more use of medical treatment, preoperative diagnosis should be done related to the risk of injury, abdominal organ damage, the need for early diagnosis, if necessary laparoscopic probing, except by Abdominal viscera injury treatment principles for treatment, but also to grasp the timing of fistula removal and related drainage methods.