鹿角状肾结石开放取石的术式选择

目的:探讨鹿角状肾结石开放取石的术式选择、预防术中意外切肾和术后失肾的措施。方法:术中根据结石形态与肾脏解剖关系选择术式。对23例鹿角状肾结石患者行开放取石术治疗,左肾鹿角状结石9例,右肾10例,双肾4例。手术前后加强防治感染,术后充分引流,以预防术后失肾。结果:手术均顺利完成,结石均于术中取尽。术中无一例意外切肾。术后1个月随访全部患者的术侧肾脏功能恢复良好。结论:对鹿角结石,根据结石的形态、分布、肾盂类型、肾积水状态和肾实质厚度等因素综合判断,选择合理的术式,能保障手术安全、干净取石。

Choice of the open surgery methods for staghorn renal calculi

Objective:To report our experience on open surgery for staghorn renal calculi and the preventive measures of complications. Methods:The clinical data of 23 cases of patients with staghorn renal calculi were analyzed retrospectively. Results:The operations for these 23 patients were carried out with all stones removed successfully. No severe complications noted in all cases. Non in this group lost kidney perioperatively. One month after operation, all patients had their renal function recovered well. Conclusions:Reasonable operation mode should be choosen according to many factors like stone distribution, renal pelvis type and the degree of nephrydrosis. Preoperative and postoperative prevention of infection and sufficient drainage are important strategies for prevention of losing kidney perioperatively.