复杂肾结石手术治疗体会(附340例报告)

Experience in the operation treatment of complex renal calculi(report of 340 cases)

目的探讨复杂肾结石的手术治疗方法。方法回顾性分析340例复杂肾结石手术的临床资料。结果术后经B超或腹平片检查,34例有残留结石,取尽结石率占89%。术中术后大出血8例,其中术中止血困难肾切除2例,术后7d大出血1例经处理无效行肾切除,术后12d大出血1例经再手术止血成功,余4例经处理出血停止。肾切除率8.8%(30/340)。结论肾窦内肾盂切开或联合肾后下部切开取石,出血少、易取尽结石、肾功能影响小,是治疗复杂肾结石的理想术式之一。

Objective To evaluate the surgical treatment of complicated renal stones. Methods The clinical data of 340 cases of the surgical treatment of complicated renal calculus retrospectively were analysed. Results Postoperative examination of abdominal X - ray and/or B - US revealed residual stone in 34 cases, and the stone - free rate was 89 % （ 276/310） ; introperative severe hemorrhage of 8 case, and 2 cases nephrectomy were performed ; postoperative 7 days nephrectomy 1 case,postoperative 12 days reoperative 1 case. The remaining 4 cases stop bleeding by treatments. The nephrectomy rate was 8.8% （30/340）. Conclusions Stone removement by intrasinusal pyelolithotomy and/or an incision of postrenal lower pole has advantages of simple operation, less hemorrhage, easy to remove all the stones and preservation of reanl function ,so it is fit for complicated renal calculus.