摘要
目的探讨斜仰截石位多镜联合一期治疗复杂性肾结石的疗效。方法 2013年1月~2015年12月105例复杂性肾结石气管插管全麻或连续硬膜外联合腰麻后,采用斜仰截石位,2组手术人员在双监视器分别监视下同时操作经皮肾镜和输尿管软镜碎石取石术。结果 105例均在斜仰截石位下顺利完成手术,术后均未出现出血和严重感染等并发症。手术时间70~120 min,平均85 min。术中出血量85~350 ml,平均120 ml。术后4~7 d复查X线或CT,肾结石一期的清石率为87.6%(92/105),输尿管结石清除率100%。7例行二期经皮肾镜取石术,4例术后配合体外冲击波碎石治疗,2例术后残余碎片直径≤3 mm未处理。92例随访2~24个月,平均8个月,情况良好,未发现有结石需要再处理。结论斜仰截石位多镜联合一期治疗复杂性肾结石清石率高,创伤小,安全有效。
Objective To investigate the effect of multiple endoscopic treatment for complex renal calculi under oblique lithotomy position. Methods A total of 105 patients with complex renal calculi were treated under tracheal intubation general anesthesia or continuous combined spinal-epidural analgesia. Patients were all placed in the oblique lithotomy position. Two groups of surgical staffs operated percutaneous nephrolithotomy and ureteroscopic lithotripsy respectively under supervisions of two monitors at the same time. Results The surgeries were technically successful in all the 105 patients. No postoperative complications occurred. The operation time was 70- 120 min（ mean,85 min）. The blood loss was 85- 350 ml（ mean,120 ml）. Postoperative re-examinations of X-ray or CT at 4- 7 days after surgery found the stone-free rate of 87. 6%（ 92 /105） for renal calculus and 100% for ureteral calculus. Second phase percutaneous nephrolithotomy was needed in 7 patients. Extracorporeal shock wave lithotripsy was conducted in4 patients. Two patients having residual remnants less than 3 mm in diameter were untreated. Postoperative follow-up for 2- 24 months（ mean,8 months） in 92 cases found no local recurrence. Conclusion Multiple endoscopic treatment for complex renal calculi under oblique lithotomy position is a powerful,effective,and safe treatment modality.
出处
《中国微创外科杂志》
CSCD
北大核心
2017年第1期59-61,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
斜仰截石位
多镜联合
肾结石
Oblique lithotomy position
Multiple endoscopy
Renal calculi
