经皮肾穿刺取石术后不留置肾造瘘管的可行性(附23例报告)

Experience of Tubeless Percutaneous Nephrolithotomy(A Report of 23 Cases)

【目的】探讨经皮肾穿刺取石手术(PCNL)后不留置肾造瘘管的指征及安全性和可行性。【方法】对23例进行PCNL术后未留置肾造瘘管的患者的临床资料进行回顾性分析。【结果】23例患者均成功实施一期碎石取石术,术后未留置肾造瘘管。其中3例术中有活动性出血,无肾盂撕裂和胸部并发症,术后结石清除率为91.3%(21例),术后2例需镇痛处理,均未出现严重并发症;平均手术时间85min,平均住院时间(8.7±2.6)d。【结论】可以在PCNL术后有选择的不留置肾造瘘管,术后痛苦少、恢复快和平均住院时间少。

[Objective]To evaluate the safety and efficacy of the tubeless percutaneous nephrolithotomy （PCNL）. [Methods] Tubeless percutaneous nephrolithotomy （PCNL） has been successfully performed in selected 23 patients. The data were analyzed for stone clearance and average time in hospital associated with tubeless PCNL respectively. [Results] All the patients were rendered stone-free or had clinically insignificant residuals with no renal puncture and no chest complications. Among them, 3 cases had active bleeding during the operation. Stone clearance was 91.3% （21/23）, only 2 patients need analgesia after operation, which the average operation time was 85 minutes, the average time in hospital was 8.7±2.6 days, and there were no significant complications. [Conclusion] Tubeless PCNL can be safely and effectively performed based on intraoperative factors. Compared with the standard procedure, tubeless PCNL has many advantages including less postoperative pain, short hospital stay and rapid recovery time.