部分无管化经皮肾镜治疗上尿路结石135例效果分析

Analysis of partial tubeless percutaneous nephrolithotomy in 135 cases with upper urinary calculi

目的探讨部分无管化经皮肾镜取石术(术后不留置肾造瘘管仅留置双J管)治疗上尿路结石的临床可行性、安全性及应用价值。方法回顾性分析我院2016年1月~2016年12月符合条件的因上尿路结石接受部分无管化经皮肾镜取石术患者资料,观察记录手术时间、术中出血、输血情况、结石清除率、术中术后并发症、术后留置导尿管及住院时间。结果 135例患者均成功实施一期部分无管化经皮肾镜取石术,手术时间20~65 min,平均48±11 min,其中F18号通道75例,F20号通道60例,单通道127例,双通道8例,所有病例未发生严重并发症,结石清除率98.5%(132/135),平均术后留置尿管3.5±0.5 d,平均术后住院时间4.5±0.5 d。结论选择性实施部分无管化经皮肾镜治疗上尿路结石安全、患者术后恢复快,效果满意。

Objective To discuss the feasibility, safety and efficacy of partial tubeless percuta- neous nephrolithotomy （using Double-J tube instead of nephrostomy tube） in the treatment of upper urinary calculi. Methods The medical records of partial tubeless percutaneous nephrolithotomy from January 2016 and December 2016 in our hospital were collected and analyzed retrospectively including operation time, bleeding and blood transfusion during the operation, stone-free rate , complication pro- files , catheter indwelling time and the length of hospital stay. Results With a total observation of the successful 135 cases, the operation time ranged from 20 to 65 minutes with a mean of 48±11 min, among which 75 cases with size F18, 60 cases with size F20, 127 cases with single-path and 8 cases with two-path. The success rate was 98.5% （132/135） with none severe complications. The average catheter indwelling time was 3.5±0.5 days and the average postoperative hospital stay was 4.5±0.5 days. Conclusion The effect of partial tubeless percutaneous nephrolithotomy in the treatment of upper uri- nary calculi is satisfactory, which is safer and fast recovered.