孤立肾合并鹿角形结石临床治疗52例报道

Therapeutic Strategies of Solitary Kideney and Staghorn Stone(Report of 52 Cases)

目的探讨孤立肾合并鹿角形肾结石治疗.方法 2006年5月至2010年11月共收治孤立肾合并鹿角形肾结石患者52例,年龄21～63岁.分析手术方法、手术时间、无石率及术前术后肾功能变化.结果 52例全部取石成功.39例采用经皮肾镜取石;13例采用开放性肾盂切开肾镜碎石取石;6例术后肌酐明显升高,经血液透析后均恢复.无大出血、感染性休克及死亡病例.

Objective To explore the therapeutic strategies of solitary kideney and staghorn stone and then to summarize the experience.Methods 52 patients,aged from 21 to 63,with solitary kidney and staghorn stone,were treated from May,2006 to November,2008.Surgical methods,operation time,the rates of free stone and the changes of renal function before and after operation were analyzed.Results All cases were treated successfully without gross bleeding,infectious shock and death.Among them,39 were via PCNL,13 via open renal pelvis combined with nephroscopic lithotripsy.Serum creatinine was found to be obviously elevated in 6 cases,and returned to be normal after hemodialysis.Conclusions The final choice of therapeutic methods of solitary kidney with staghorn stone is closely related with renal function.The cases with normal renal function or normal after renal drainage could be treated with PCNL,while others with poor renal function should first be treated with renal drainage and hemodialysis,and then be treated with open surgery until their renal functions are recovered