标准通道PCNL一期处理感染性肾结石.pdfVIP

2016 年 7 月 ·论 著 · 标准通道 PCNL 一期处理感染性肾结石 1 2 3 3 1 1 1 1 梅傲冰 肖 峰 贾本忠 孙 发 陈 梅 何 翔 康 婷 刘志明 1.贵州省贵阳市第二人民医院泌尿外科 贵州贵阳 550081 ； 2.贵航贵阳医院泌尿外科 贵州贵阳 550009 ；3.贵州医科大学附属医院泌尿外科 贵州贵阳 550004 【摘要】目的 探索标准通道 PCNL一期处理感染性肾结石的疗效及可行性。方法 对 48例肾结石合并感染患者，术前行尿培养， 常规抗感染 3-5 天后行一期标准通道 PCNL 超声或联合气压弹道碎石处理肾结石及吸出脓液。结果 34 例病人结石一期全部取尽，5 例残留结石较多较大经保留通道二期取石，6 例残留结石较小行 ESWL 后无结石残留，3 例双肾结石因经济原因只行单侧手术，2 例结 石较大、手术时间较长者出现全身炎症反应综合征（systemic inflammatory response syndrome，SIRS），给予积极治疗好转。余无 肾周脓肿、脓毒血症、感染性休克、大出血等严重并发症，随访 2-24 个月，平均 10 个月，肾功能、肾集合系统分离好转。结论 标 准通道 PCNL一期处理感染性肾结石疗效确切，安全无严重并发症，可作首选。 【关键词】标准通道；经皮肾镜取石术；一期手术；感染性结石 Standard-tract PCNL for Infection-induced Renal Calculi at One-stage in 48 Cases MEI Ao-bing1，XIAO Feng2，JIA Ben-zhong3，SUN Fa3，CHEN Mei1， LIANG Xan-quan1，HE Xiang1，KANG Ting1，LIU Zhi-ming1 1The Division of Urology at The Second People’s Hospital of Guiyang，Guiyang Guizhou.550081.China；2The Division of Urology at The Guihang Hospital of Guiyang，Guiyang 550009，China；3The Division of Urology at The Affiliated Hospital of Guizhou Medical University，Guiyang 550004，China Abstract Objective：To assess the curative effects and feasibility of standard-tract PCNL in treating infection-induced renal calculi。Methods：48 patients with infection-induced renal calculi were given urine culture and general anti-infection before Operation，then we use the methods of Standard-tract PCNL or pneumatic lithotripsy for infection-induced renal calculi after 3-5days and we sucked out the patients’ pus.Results：Of 48 patients，the renal calculi were completely removed at one-stage in 34 cases.5 patients were given two-staged clearance because of lots of Residual stones.6 patients was given ESWL because of few Residual stones.3 patie