开放性手术治疗鹿角形肾结石不同术式体会（医疗卫生论文资料）.docVIP

开放性手术治疗鹿角形肾结石不同术式体会（医疗卫生论文资料） 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：开放性手术治疗鹿角形肾结石不同术式体会 1 1 临床资料 2 2 讨论 4 文2：开放性手术治疗肾输尿管结石的体会 6 1 临床资料 7 2 讨论 7 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 11 正文 开放性手术治疗鹿角形肾结石不同术式体会（医疗卫生论文资料） 文1：开放性手术治疗鹿角形肾结石不同术式体会 Compreheion of different operation types treating deerhorn kidney stone SUN Gui-yang，GAO Jian-bang，YANG Lian-feng，WANG Xin (Department of Urology，the 208th Hospital of PLA，Changchun 130062，China) Abstract：Objective To explore the method and the curative effect of different operation The clinical data of 45 cases with complex kidney stones by different surgical operation methods was reviewed and 23 cases with cutting open kidney substance and taking stone in the environment of stopping kidney artery and artery is stopped for 25~65 min. The bleeding amount is 80~400 ml and the operation time is 90~170 min. 22 cases with cutting open kidney substance and taking stone in an environment of interrupting and imperfectly stopping the kidney pedicel. The bleeding amount of 15 patients is short of 200 ml， without blood trafusion. The time of taking stone from kidney substance is short (average min) and the renal function of the trouble kidney is normal after operation. Concluslon The selection of operation type is according to the size and shape of stone， the last time and difficult degree of surgery in the treatment of deerkorn kidney stone。 Key Words：Deerhorn kidney stone;Surgical operation 肾结石是泌尿外科的常见病，其治疗方法主要有中药排石、溶石法、体外震波碎石法、弹道碎石及外科手术。其中外科手术治疗又有多种方法，本文通过对鹿角形肾结石的结石取出率、术后肾功能恢复情况进行比较，探讨不同术式治疗鹿角形肾结石的优劣性。自2000年始，我院采用不同术式治疗鹿角形肾结石45例取得了较好的效果，现报告如下。 1 临床资料 一般资料:低温阻断肾动脉肾实质切开取石组23例，均为肾内型肾盂肾结石，男12例，女11例，年龄33～65岁，平均45岁，左肾结石12例，右肾结石11例，结石最大直径。间断性不完全性肾蒂阻断行肾实质切开取石组22例，也均为肾内型肾盂肾结石，其中男12例，女10例，年龄26～72岁，平均46岁，左肾结石11例，右肾结石11例，1例为体外冲击波碎石治疗失败而改为开放性手术。以上病例术前均经B超、KUB、IVP、CT及逆行肾盂造影等影像学检查明确诊断。 手术方法 低温阻断肾动脉肾实质切开取石组：取第12肋床斜切口， 切除12肋，切开肾周筋膜，充分显露肾脏，游离肾脏及肾蒂，仔细分离出肾动脉，快速静脉注射肌苷2g和20%甘露醇250ml，用无损伤钳钳夹动脉，肾周加入碎冰冷却15min。肾脏变软、变白，沿肾背侧外缘相对无血管区(brod