经皮肾穿刺取石术中经肋间穿刺的安全性评估

目的评价经皮肾穿刺取石术中经肋间穿刺途径的安全性和有效性。方法我科2007年1—9月共行经皮肾穿刺取石术231例,其中97例(42%)为经肋间穿刺建立通道。观察行肋间穿刺患者的结石清除率及其并发症。结果97例经肋间穿刺患者的结石清除率为71.3%(69/97例);并发症发生率13.4%(13/97例):其中严重出血5例,有4例需要输血,胸腔积液3例,选择性肾动脉栓塞1例,感染性休克1例。结论经第11肋间进行穿刺存在一定风险,需严格掌握适应证,术后应常规进行胸片检查以排除胸部并发症。

Safety Evaluation of Intercostal Puncture in Percutaneous Nephrolithotomy

Objective To evaluate retrospectively the safety and efficacy of intercostal puncture in percutaneous nephrolithotomy(PCNL).Methods There were a total of 231 patients undergoing PCNL,in 97 of whom tunnels were established for intercostal puncture(42%).Data of stone clearance and complications of patients undergoing intercostal puncture were analyzed.Results In 97 intercostal puncture patients,stone clearance was 71.3%(69/97);incidence rate of complications was 13.4%(13/97):five of them presented with severe bleeding,3 with pleural effusion,1 with selective thrombosis of renal artery,1 with septic shock,and 4 needed blood transfusion.All patients recovered uneventfully.Conclusion These results indicate that intercostal puncture is used widely in spite of some acceptable complications.A chest X-ray after surgery should be routine,to detect any complication.