Ⅰ期经皮肾镜超声碎石术治疗结石性脓肾体会(附23例报告)

目的 探讨一期经皮肾镜超声碎石术治疗结石性脓肾的可行性、安全性及临床疗效.方法 回顾分析23例应用经皮肾镜超声碎石术治疗结石性脓肾患者的临床资料.结果 23例均成功完成Ⅰ期手术治疗并保存肾脏,Ⅰ期清石率为78.3％(18/23 ); 2例出现术中血压急剧下降,考虑为感染性休克,改为置肾造瘘管引流,再Ⅱ期处理结石；1例术后出血严重,经保守治疗效果欠佳,行选择性肾动脉介入栓塞治愈.结论 Ⅰ期经皮肾镜超声碎石术治疗结石性脓肾是一种可行、安全、有效的方法,值得临床尝试.

Stage-I percutaneous ultrasonic lithotripsy for upper urinary calculi complicated with pyonephrosis ( a report of 23 cases )

Objective To investigate the feasibility, safety and clinical efficacy of stage-I percutaneous ultrasonic lithotripsy for upper urinary calculi complicated with pyonephrosis.. Methods Retrospectively analyzed the clinical data on 23 patients with upper urinary calculi complicated with pyonephrosis who had undergone stage-I percutaneous ultrasonic lithotripsy. Results The procedure was successfully performed on all the patient. No complications occurred. The stage-I rate of stone removal was 78.3% （ 18/23 ）. Two patients had a sharp decline in blood pressure during surgery due to septic shock and they received nephrostomy drainage for phase II process of stone. One patient was cured with selective renal artery embolization because of severe bleeding and no response to conservative treatment. Conclusions stage-I percutaneous ultrasonic lithotripsy for upper urinary calculi complicated with pyonephrosis is feasible, safe, and effective. It is worth trying clinically.