可视穿刺式经皮肾镜碎石术治疗无积水肾结石的疗效分析（附39例报告）

doi:10.19558/j.cnki.10-1020/r.2020.05.006

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摘要 目的：探讨使用可视穿刺式经皮肾镜碎石术治疗无积水肾结石的临床疗效。方法：回顾性分析2016年8月–2018年5月采用德国铂立可视穿刺系统行F_4.8超微通道、F₁₈微通道、超微通道联合F₁₈微通道经皮肾镜钬激光碎石治疗无积水肾结石患者39例,对通道建立时间、结石清除率、手术总时间、术后住院时间及手术并发症等临床资料进行分析。结果：可视通道穿刺成功率100.0%（39/39）,可视穿刺F_4.8超微通道建立时间（3.6±0.4）min、F₁₈微通道建立时间（7.9±1.0）min、碎石清石时间（46.4±19.6）min,手术总时间（72.4±13.8）min,术后平均住院（4.9±1.2）d,平均血红蛋白下降（13.4±2.9）g/L,一期结石清除率94.9%（37/39）,所有患者术中无大出血、胸膜损伤和肾周其他脏器损伤,术后无发热、脓毒血症等并发症。结论：使用可视穿刺式经皮肾镜碎石术治疗无积水肾结石穿刺精准安全、碎石清石率高、手术并发症少,是一种患者满意度高、临床疗效好的治疗方法。

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	赵贵成
	柯昌兴
	何星成
	张怡
	马兴永
	蒋昌毅
	龚年东

关键词 ：可视穿刺, 经皮肾镜碎石术, 无积水肾结石

Abstract：Objective： To investigate the clinical efficacy and safety of visible precise puncture combined with PCNL in the treatment of renal calculi without hydronephrosis. Methods： A retrospective analysis was performed on 39 cases of renal calculi without hydronephrosis from August 2016 to May 2018, who underwent micro-channel or mini-channel or multi-channel of micro and mini lithotripsy combined with PCNL visible precise puncture holmium laser lithotripsy. Results： The visible precise puncture was established successfully in all 39 cases, the mean establishing time of F_4.8 micro-channel and F18 mini-channel by visible puncture was （3.6±0.4） and （7.9±1.0） min respectively, the mean lithotripsy time was （46.4±19.6） min, the mean operating time was （72.4±13.8） min, the mean postoperative hospital stay was （4.9±1.2） days, the first clearance rate was 94.9% （37/39）, and no massive haemorrhage, pleural injury, intestinal injury, sepsis, or other serious complications occurred. Conclusions： The visible precise puncture combined with PCNL for the treatment of renal calculi without hydronephrosis possesses the advantages of precise puncturing, less damage, low complication incidence, with high fruiting rate and outstanding curative effects, which can be popularized in clinical practice.

Key words： visible precise puncture percutaneous nephrolithotomy renal calculi without hydronephrosis

收稿日期: 2018-07-22

ZTFLH:	R699.2
	R692.4

基金资助:云南省医疗卫生单位内设研究结构科研基金项目(2016NS260); 云南省卫生和计划生育委员会医学学科带头人项目（D-201655）

通讯作者: 柯昌兴,kene126@126.com

引用本文:

赵贵成, 柯昌兴, 何星成, 张怡, 马兴永, 蒋昌毅, 龚年东. 可视穿刺式经皮肾镜碎石术治疗无积水肾结石的疗效分析（附39例报告）[J]. 微创泌尿外科杂志, 2020, 9(5): 316-320.
ZHAO Guicheng, KE Changxing, HE Xingcheng, ZHANG Yi, MA Xingyong, JIANG Changyi, GONG Niandong. Clinical analysis of visible precise puncture combined with PCNL for the treatment of renal calculi without hydronephrosis: Report of 39 cases. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 316-320.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1620.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I5/316

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