经皮肾镜治疗肾脏多发性结石并发症的防治

Prevention and Control of Complications of Percutaneous Nephroscope Set in Treatment of Renal Multiple Stones

目的探究肾脏多发性结石经皮肾镜治疗后并发症预防及治疗措施。方法方便选择该院2014年1月—2017年3月收治的106例行经皮肾镜治疗的肾脏多发性结石患者,统计分析106例患者术后并发症情况,对患者的并发症表现类型、原因及干预治疗结果进行分析。结果 106例患者中有13例并发症发生,发生率为12.26%,出现术后出血5例、腹腔积液3例、胸腔积液2例、肾盂破裂1例、感染1例、结肠穿孔1例;13例并发症患者经干预治疗后,所有患者痊愈出院,治愈达到100.00%,未出现有残疾和死亡。结论肾脏多发结石经皮肾镜治疗后术后并发症发生率高,可导致患者出现术后大出血、腹腔积液、胸腔积液等并发症,类型多样复杂,在手术方案的设定中要针对患者的肾结石分布、大小、数量选择患者的体位、碎石方式和手术通道,围手术期做好出血、感染的预防,术中减少对邻近脏器和血管的损伤,以减少经皮肾镜治疗患者术后并发症的发生。

Objective To study the prevention and treatment measures of complications of percutaneous nephroscope set in treatment of renal multiple stones. Methods 106 cases of renal multiple stones treated with percutaneous nephroscope set admitted and treated in our hospital from January 2014 to March 2017 were selected and the postoperative complications were counted and analyzed, and the manifestation type and cause of complications and intervention treatment effect were analyzed. Results Of 106 cases of patients, there were 13 cases with complications, and the incidence rate was 12.26%, after operation, there were 5 cases with hemorrhage, 3 cases with seroperitoneum, 2 cases with pleural effusion, 1 case with rupture of renal pelvis, 1 case with infection and 1 case with perforation of colon, after treatment, all patients were cured and discharged, and the cure rate was 100.00%, no disable and death cases. Conclusion The incidence rate of postoperative complications of percutaneous nephroscope set in treatment of renal multiple stones is high, which can lead to the complex complications such as postoperative hemorrhea, seroperitoneum set and pleural effusion, and we should select the body position, detritus method and operation channel, do a good job in the prevention of bleeding and infection during the preoperative period and reduce the injury of ？adjacent visceral organ and blood vessel in order to reduce the occurrence of postoperative complications of patients with percutaneous nephroscope set.