微创经皮肾镜取石术并发症的临床分析及处理

Clinical analysis and treatment of complication of minimally invasive percutaneous nephrolithotomy

目的:探讨经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)的并发症及其处理方法。方法:2002年至2007年我院实施PCNL528例,男351例,女177例,其中肾结石236例,输尿管结石212例,肾结石合并输尿管结石80例。结果:本组患者均治愈出院,无一例死亡,发生并发症31例,其中大出血17例,胸腔积液2例,结肠穿孔1例,发热8例,腹腔积液3例。结论:PCNL为微创手术,但在技术不熟练的情况下风险较大,加强并发症的防治有利于此项技术的开展。

Objective：To investigate the complications of minimally invasive percutaneous nephrolithotomy（PCNL） and their management.Methods：The data of 528 cases of PCNL from 2002 to 2007 were reviewed,including 351 males and 177 females.In the 528 cases,236 cases had simple nephrolithiasis,212 cases had simple ureterolithiasis,80 cases had nephrolithiasis combined with ureterolithiasis.Results：Among the 528 cases of PCNL,complications occurred in 31 cases.Of the 31 cases,17 cases had massive hemorrhage,2 cases had pleural effusion,1 case had colon perforation,8 cases had febricity,3 cases had hydroperitoneum.All patients were cured by conservative treatment.There was no death in the group.Conclusions：PCNL is a minimally invasive operation.However,it has obvious risk if the surgeon＇s skill is not proficient.The improvement in the prevention and management of complications can promote the application of this procedure.