微创经皮肾镜取石术治疗上尿路结石的并发症及其对策研究

目的 探讨微创经皮肾镜取石术（MPCNL）治疗上尿路结石的手术并发症及其防治对策.方法 回顾性分析2008年4月～2010年6月本院应用MPCNL治疗上尿路结石312例的临床资料,对手术并发症和防治措施进行分析和探讨.结果 312例患者,共行341例次手术,术中、术后共发生并发症71例次,其中胸膜损伤、气胸2例次;术中大出血3例次;未能成功留置双J管5例次;术后高热、感染56例次;术后肾造漏管脱落3例次;术后迟发大出血1例次;尿外渗1例.经采取相应措施均治愈.无腹腔脏器损伤.结论 术中术后大出血、术后感染、气胸、尿外渗等是MPCNL较严重而常见的并发症,开展MPCNL时加强并发症的防治至关重要.

The reseach on the countermeasure and the treatment of upper urinary calculi by the way of minimally invasive per- cutaneous nephrolithotomy

Objective To explore the countermeasure and the treatment of upper urinary calculi by the way of minimally invasive pereutaneous nephrolithotomy（MPCNL）. Methods Retrospective analysis of the clinical data of 312 patients who were treated the upper urinary calculi by the way of MPCNL from June 2008 to April 2010 was conducted as well as the complications of surgery and prevention measures. Resulis 312 patients were conducted 341 surgeries. 71 cases of the intrao-perative and postoperative complications oecured, including pleural damage,2 cases of pneumothorax, and three cases of hemorrhea, fail encumbrance of jtube 5 times,56 cases of infection and hyperpyrexia, a heavy bleeding after a long time and urinous infiltration. Taking appropriate measures,all were healed without abdominal organs damage. Conclusion Intraoperative and postoperative bleeding, postoperative infection, pncumothorax and urious infiltration were serious and common complications when MPCNL was conducted, so it was vital to prevent the complications.