肾造瘘管在PCNL术后的应用价值

目的总结经皮肾镜碎石术（PCNL）术后常规留置肾造瘘管在术后并发症处理中的应用价值。方法对2010年3月至2015年24220例肾结石及输尿管上段结石患者的临床资料进行回顾分析，探讨PCNL术后常规留置肾造瘘管在PCNL术后的应用价值。结果28例患者术后残留细小结石通过肾造瘘管排出体外。195例患者通过夹闭肾造瘘管1h后得到有效的止血，23例患者经肾造瘘管注射零度的冰水及去甲肾上腺素止血。3例肾动脉出血的患者在肾造瘘管为参照定位出血点对其有效栓塞，5例患者术后通过留置肾造瘘管引流脓液，控制感染，为二次PCNL做准备。7例鹿角型结石患者I期碎石后留置肾造瘘管为Ⅱ期PCNL处理残留结石保留通道。结论PCNL术后患者应常规留置肾造瘘管，肾造瘘管在PCNL术后并发症处理中发挥重要的作用，并为再次PCNL手术保留通道。

Objective To summarize the function of nephrostomy tube in desling with the postoperative complications of the patients after the percutaneous nephrolithotomy （ PCNL ） . Methods To analysis the clinical data include 220 patients who were diagnosed kidney stone or upper urinary calculi from March 2010 to February 2015 in the way of retrospective study.Results The residual stones after surgery were removed by nephrostomy tube in 28 cases.195 patients were staunched the bleeding through occluding the nephrostomy tube one hour and 23 patients were injected ice water and noradrenaline to stop the bleeding .Using the nephrostomy tube as a reference to seek out the renal artery injure in 3 patients, The pus can be exhausted through nephrostomy tube to control infection in five patients who preparing for the next PCNL. The nephrostomy tube keep the green therapy channel for seven staghorn calculi patients when they are going to take the second surgery. Conclusion The nephrostomy tube which have a great effect of dealing with the postoperative complications after the PNCL is a green therapy channel when the patients need to take the second surgery again.