Standard-tract percutaneous nephrolithotomy for patients with chronic renal insufficiency
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摘要: 目的:探讨标准通道经皮肾镜取石术(PCNL)在慢性肾功能不全患者中应用的安全性及有效性。方法:回顾性分析2005年12月~2010年11月行PCNL手术治疗的慢性肾功能不全病例,共92例患者,146次手术,统计手术效果并比较围手术期血肌酐水平、血色素、红细胞压积的变化。结果:一期手术清石率46.7%,总清石率64.1%,出血、术后发热、结石残留是主要并发症;术后与术前比较,血红蛋白、红细胞压积明显降低,具有统计学意义;血肌酐水平无显著性变化。结论:对于慢性肾功能不全患者,标准通道PCNL是安全有效的,手术对肾功能的近期影响不明显。Abstract: Objective:To evaluate the efficacy and safety of F24-tract percutaneous nephrolithotomy (PNL) in treating patients with chronic renal insufficiency. Method:A total of 92 patients with renal insufficiency who underwent 146 times F24-tract percutaneous nephrolithotomies since December 2005 to 2010 November were retrospectively analyzed, clinical effect and complications, the variations of serum creatinine, hemoglobin and HCT changes before and after operation were statistical analyzed.Result:The stone-free rate after one session operation were 46.7%, the last stone-free rate were 64.1%, major complications were hemorrhage, postoperative fever and stones residue. Hemoglobin, HCT reduced significantly postoperation, while there were no significant changes in Serum creatinine.Conclusion:For chronic renal insufficiency cases, F24-tract percutaneous nephrolithotomy is safe and effective, the operation has no significant influence on kidney function.
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Key words:
- percutaneous nephrolithotomy /
- renal insufficiency /
- stone clearance rate
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