微创保肾手术治疗结石性脓肾

Treatment of calculous pyonephrosis with minimally invasive surgery which saved the kidney

目的探讨结石性脓肾行微创保肾手术治疗的疗效和价值。方法对36例结石性脓肾患者,Ⅰ期行微创经皮肾穿刺造瘘术(minipcN),Ⅱ期行经皮肾输尿管镜取石术或经尿道输尿管镜取石术。结果36例Ⅰ期minipcN成功率100%,Ⅱ期结石取净率86%(31/36);术后随访30例,患肾功能恢复或部分恢复24例(80%),术后发生肾萎缩5例(16.7%),患肾切除1例(3.3%)。结论微创腔内手术具有安全有效、创伤性小、保肾率高的优点,适合结石性脓肾患者的保肾治疗。

Objective To investigate the feasibility and value of the treatment os calculous pyonephrosis with minimally invasive surgery which saved the kidney. Methods 36 cases of calculous pyonephrosis were treated by percutaneous nephrosfomy in the first stage, and then by percutaneous neplurolithotomy or thransarethral ureterscopy. Results The rate of PCN in the first stage attained to 100 % ,and the rate of fetching the calculi was 86 % （31/36）. 30 cases after surgery had been followed up and valued. The renal function returned to some extent in 80 % （24/30） ,renal atrophy was observed in 16 % （5/30） and nephrectorry in 3.3 % （1/30）. Conclusion Mini-endourological surgery had the following metites：safe and effective,invasive, the high rate of saving the kidney and so on,so it is adapted to the treatment of calculous pyonephrosis.