微创经皮肾镜治疗2型糖尿病患者上尿路结石

Minimally invasive percutaneous nephrolithotomy for treatment of ureteral calculi in patients with type 2 diabetes mellitus

目的探讨微创经皮肾镜治疗2型糖尿病患者上尿路结石的方法和注意事项。方法2004年7月～2007年5月住院的35例患有2型糖尿病的上尿路结石患者,在积极控制血糖和其他内科疾病的基础上,行微创经皮肾镜取石术。结果35例治疗均获成功,患者I期取石33例,Ⅱ期取石2例,均为单通道取石。无1例改开放手术,手术时间平均为125min,结石清除率86.7%。术中术后大出血3例,2例经夹管、止血药物保守治疗,需输血患者1例,无邻近脏器损伤、肾脓肿、上尿路穿孔等严重并发症。术后发热患者4例,加强抗生素治疗后体温正常。4～8d后拔除肾造瘘管,平均6d。住院7～23d,平均14d。结论微创经皮肾镜取石术治疗糖尿病患者上尿路结石,安全可靠。熟练的经皮肾镜取石技术和血糖的良好控制以及抗生素的合理使用是治疗糖尿病患者上尿路结石的关键。

[Objective] To assess the efficacy and announcements of minimally invasive percutaneous nephrolitho-tripsy (MPCNL) for patients with upper ureteral calculi and typeⅡ diabetes mellitus. [Methods] Retrospective investigation was performed on 35 cases suffering from upper ureteral calculi and type Ⅱ diabetes mellitus, who were treated with MPCNL from July 2004 to May 2007 after control of serum glucose and treatment of other medical diseases. [Results] The operation succeeded in 35 cases, immediate phase Ⅰ lit...