185例肾结石手术治疗临床分析

目的探讨肾结石开放性手术治疗增多的原因并评估手术治疗的效果。方法对185例肾结石患者手术前后的临床资料进行回顾性分析。结果鹿角型结石83例，多发性结石122例；术前已体外碎石（ESWL）126例，22例无症状者首次治疗就选择了开放手术。结石残存率18．9％（35／185），配合ESWL后残石率在3．8％以下；伴肾功能不全12例，手术后肾功能不全治疗有效率为100％，治愈率83．3％（10／12）。结论无效碎石病例的积累是肾结石开放手术增多的重要原因，手术方式和时机取决于患者的具体情况，恰当的术式能获得满意的疗效。无症状肾结石应引起高度重视。

Clinical Analysis of the Surgical Treatment in 185 Cases with Kidney Calculi

Objective To study the reason for the increase of open surgery for kidney calculi and to evaluate the effect of surgical treatment.Methods A retrospective analysis was made to the clinical data of 185 cases with kidney calculi before and after surgical treatment.Results Staghom calculi were found in 83 cases,multiple calculi in 122 cases;126 cases had received Extracorporeal Shock Wave Lithotripsy(ESWL) before the surgical treatment;22 cases with no symptoms took open surgery as the first treatment;the residual stone rate was 18.9% (35/185) while the residual stone rate decreased to 3.8% after ESWL was added;in the 12 cases with kidney failure,the effective rate was 100% after surgery and the curative rate was 83.3%(10/12).Conclusion The increase of ineffective ESWL cases is the important reason for open surgery of kidney calculi,the operation style and time depend on the actual condition of the patients,and proper style may lead to satisfactory curative effect;more attention should be paid to the cases with no symptoms.