经皮肾镜超声碎石治疗感染性肾结石体会

The Experience of Treatment on Infectious Kidney Stones by Percutaneous Nephroscope Ultrasonic Lithotripsy

目的探讨经皮肾镜超声碎石术治疗感染性肾结石的安全性和疗效。方法采用经皮肾镜超声碎石治疗感染性肾结石85例。结果 76例1次取净结石。4例术后残留结石>1 cm,1周后沿原肾造瘘口2次碎石;5例术后残留结石<1 cm,行体外冲击波碎石后排净。全部病例未出现术中或术后大出血、肾周脓肿、邻近脏器损伤等并发症。术中或术后出现全身炎症反应综合征3例,均治愈。结论经皮肾镜超声碎石是治疗感染性肾结石的一种有效的方法,但存在一定风险,应引起重视,并积极预防这些风险发生。

Objective To investigate the safety and effects of Percutaneous nephroscope ultrasonic lithotripsy in treating infectious kidney stones. Method 85 cases with infectious kidney stones were treated by percutaneous nephroscope ultrasonic lithotripsy. Results The stones were completely removed one - time in 76 cases, bigger than I residual calculi was found in 4 cases of postoperative patients, and secondary lithotripsy were performed through prvious kidney fistul after one week. 5 casese was founded remnant stone less than lcm, and got stone- free after extracorporeal shock wave lithotripsy （ESWL）. No severe complications was founded in all cases including intraoperative or postoperative bleeding, perinephric abscess, injuring to adjacent organs. Systemic inflammatory response syndrome happened in 3 pations intraoperative and postoperative, and be cured all. Con- clusion Percutaneous nephroscope ultrasonic lithotripsy is effective for infective kidney stones, but accompany with certain risk also, which should be taken seriously, and be prevented actively from complications happened.