摘要
目的:探讨经皮肾镜取石术(PCNL)治疗结石感染性肾积水的临床疗效与分期手术选择。方法:回顾性分析2011年1月~2013年10月采用PCNL治疗65例结石感染性肾积水患者的临床资料,37例Ⅰ期肾造瘘引流后再Ⅱ期行PCNL(A组),28例Ⅰ期行PCNL(B组)。比较两组手术时间、术中出血量、并发症发生率、结石清除率及住院时间等。结果:A组PCNL术中出血量、PCNL术后住院时间、并发症发生率明显少于B组(P〈0.05),分别为(55.2±9.4)ml vs(97.3±13.6)ml、(6.4±1.5)d vs(10.5±2.7)d、10.8%vs 46.4%,A组一期结石清除率高于B组,为89.2%vs 78.6%(P〈0.05)。结论:Ⅰ期肾造瘘引流后再Ⅱ期行PCNL治疗结石感染性肾积水安全、有效;Ⅰ期PCNL治疗结石感染性肾积水需谨慎选择。
Objective: To investigate the clinical efficacy and staging strategy of percutaneous nephrolithotomy (PCNL) for upper urinary calculi complicated with infected hydronephrosis. Method: Clinical data of 65 patients with stone infected hydronephrosis by PCNL from January 2011 to October 2013 were retrospectively analyzed. Thirty-seven patients were treated by one-stage percutaneous nephrostomy and second-stage PCNL (group A), while 28 patients were treated by one-satge PCNL (group B). The operative time, intraoperative blood loss, the stone free rate, complication incidence rate and hospital stay were compared between the two groups. Result: The intraoperative blood loss was less in group A (55.2±9.4) ml vs (97.3±13.6) ml, P 〈0. 052, and postopera- tive hospital stay of group A was shorter than that of group B (6.4±1.5) d vs (10.5±2.7) d, P〈0. 052. The complication incidence rate was lower in group A (10.8% vs 46.4%, P 〈0.05). The stone free rate was higher in group A (89.2% vs 78.6M, P 〈0.05). Conclusion: The strategy of one-stage percutaneous nephrostomy and second-stage PCNL is safe and effective for the treatment of stone infected hydronephrosis. However, one-stage PCNL for upper urinary calculi complicated with infected hydronephrosis should be selected carefully.
出处
《临床泌尿外科杂志》
2015年第1期37-39,42,共4页
Journal of Clinical Urology
关键词
经皮肾镜取石术
结石
肾积水
感染
percutaneous nephrolithotomy
calculi
hydronephrosis
infection