肾后基段间区切开取石术治疗复杂性肾结石

Nephrolithotomy at the posterior basal segment for complex nephritic stone

目的 :探讨肾后基段间区切开取石术治疗复杂性肾鹿角状或铸状结石的疗效。方法 :应用肾后基段间区切开取石术治疗复杂性肾鹿角状或铸状结石 31例。结果 :术中输血 8例、平均输血1 1 6ml;术后 3周 KUB加 IVU复查 ,肾脏显影正常 ,积水减少 ,无肾内外狭窄 ;结石一次性取净2 6例 ,残余结石 5例 ,其中 4例经 ESWL治愈 ,1例结石自然排净。结论 :肾后基段间区切开取石术具有术中出血少、结石一次性取净率高、肾集合系统破坏小、肾功能受损轻及便于处理残余结石等优点。适合于肾内型肾盂鹿角状或铸状结石并发肾盏多发性结石的治疗。

Purpose:To study the curative effect of nephrolithoto my at the posterior basal segment for staghorn calculus and other complex calculus of kidney.Methods:We applied nephrolithotomy at the posterior basal segment for complex neophrolithiasis in 31 cases.Results:8 cases needed intraoperative blood transfusion and the mean amount of blood was 116 ml.Three weeks postoperatively KUB & IVU indicated normal kidney development,improved hydronephrosis,no intrarenal and extrarenal stricture.Single-time clearance in 26 cases and remanent calculus in 5 cases,in which 4 case were cured by ESWL and 1 case discharged by self.Conclusions:Nephrolithotomy at the posterior basal segment has the advantages of little intraoperative bleeding,high single-time clearance rate,slight impairment of renal function,little damage of renal collecting system and it is favorable for the operative treatment for the remanent calculus.This method is suitable for intrarenal staghorn and other complex pyelolithiasis with multiple calyceal calculus.