原位低温肾动脉阻断肾切开术治疗肾鹿角形结石

In situ hypothermia and occlusion of renal artery for staghorn nephrolithotomy

目的 探讨肾鹿角状复杂性结石的治疗方法。方法 对 6 4例患者采用原位低温阻断肾动脉、肾实质切开取石术治疗。术时结合应用超声波探测小盏结石准确位置。结果 术中出血少 ,有 2 0例输血 1～ 2U ,术后恢复顺利 ,1周内血尿消失 ,无继发性出血及肾切除 ,腹部X线平片示 4例残留小结石 ;6 0例获随访 ,IVU和B超、CT示肾功能基本恢复正常。结论 原位低温阻断肾动脉行肾实质切开取石术加上超声引导 。

Objective To investigate surgical treatment for complicated staghorn renalcalculi.Methods We used in situ hypothermia and occlusion of renal artery and incision of nephridioplasm to perform nephrolithotomy in 64 cases.We also used applied ultrasonic wave to detect the exact position of minor stone during the operations.Results The patients experienced less bleeding during the operation,among whom 20 cases required 1～2 unit blood transfusion.They recovered uneventfully postoperatively:gross hematuria disappeared within one week,no secondary bleeding or obliged nephrectomy occurred.4 cases had small residual stone each on the X ray film and 60 cases were followed up by IVU and ECT.The function of the operated kidney recovered to nearly normal.Conclusion In situ hypothermia and occlusion of renalartery and incision of nephridioplasm,along with ultrasinic wave detection to perform nephrolithotomy for complicated staghorn renal calculi is an effective,safe and reliable operative procedure.