低温阻断肾蒂肾实质切开取石术治疗复杂性肾结石20例分析

目的探讨低温阻断肾蒂肾实质切开取石术治疗复杂性肾结石的临床效果。方法对2008年1月～2010年1月间在我院接受低温阻断肾蒂肾实质切开取石术治疗的复杂性肾结石患者20例进行前瞻性分析,总结治疗效果和经验。结果本组患者血流阻断时间平均(28.25±2.20)min,出血量平均(145.60±2.24)mL,手术历时平均(122.46±2.26)min,术后血尿时间平均(5.04±1.20)d。术后均无肾周血肿和尿瘘,术后复查仅2例残余较小的砂粒状结石,所有患者术后血肌酐均恢复正常,治愈率达80.00%,总有效率达100%。IVU患肾于5min显影16例,10min显影1例,15min显影3例,30min显影0例。结论低温阻断肾蒂肾实质切开取石术治疗复杂性肾结石的临床效果确切,并发症少,值得临床广泛应用。

Analysis on Treatment of Complex Renal Calculi with Lithotomy of Renal Parenchyma by Hypothermic Blockage of Renal Pedicle of 20 Cases

Objective To investigate the clinical effect of lithotomy of renal parenchyma by hypothermic blockage of renal pedicle in treating the complex renal calculi.Methods 20 cases with complex renal calculi who were treated with lithotomy of renal parenchyma by hypothermic blockage of renal pedicle in our hospital from January 2008 to January 2010 were analyzed prospectively,the clinical effect and experience were summarized.Results The average blood stream blockage time was(28.25 ± 2.20) minutes,the average hemorrhage was(145.60 ± 2.24) mL,the average operation time was(122.46 ± 2.26) minutes and the average hematuria time after operation was(5.04 ± 1.20) days.There was no case with perirenal hematoma and urinary fistula,and there were only 2 cases with granulous stone.The serum creatinine put back,and the recovery rate was 80.00% and total effective rate was 100%.There were 16 cases with visualization in 5 minutes,1 case with visualization in 10 minutes,3 cases with visualization in 15 minutes and no case with visualization in 30 minutes.Conclusion The clinical effect of lithotomy of renal parenchyma by hypothermic blockage of renal pedicle in treating the complex renal calculi is obvious and the complications are few,so it is worth being used widely.