【摘要】：目的：探討微通道經(jīng)皮腎鏡取石術(shù)治療腎結(jié)石術(shù)中并發(fā)胸腹腔積液的診斷和處理方法。方法：2008年4月至2013年4月320例腎結(jié)石患者接受微通道經(jīng)皮腎鏡取石，對其中10例術(shù)中并發(fā)胸腹腔積液的患者資料作回顧性分析。結(jié)果：本組男性8例，女性2例,年齡31～59歲,平均年齡39.5歲；左側(cè)腎結(jié)石7例，右側(cè)3例，結(jié)石大小1.0cm×2.0cm×2.5cm～1.8cm×2.5cm×4.0cm，為鑄型結(jié)石，并發(fā)輕度腎積水3例。在B超定位下經(jīng)第11肋間或12肋骨下穿刺，術(shù)中發(fā)現(xiàn)6例輕度胸腹腔積液，2例出現(xiàn)嚴(yán)重的胸腹腔積液，，另術(shù)后發(fā)現(xiàn)2例輕度胸腹腔積液，分別經(jīng)胸腔引流、腹腔引流和保守治療后治愈。本組微通道經(jīng)皮腎鏡取石術(shù)治療腎結(jié)石術(shù)中并發(fā)胸腹腔積液發(fā)生率為3.1%（10/320）,9例隨訪3月無異常發(fā)現(xiàn)，1例腎功能無改善。結(jié)論：微通道經(jīng)皮腎鏡取石術(shù)治療腎結(jié)石術(shù)中可并發(fā)胸腹腔積液,術(shù)中B超檢查可明確診斷；嚴(yán)重的胸腹腔積液術(shù)中必須立刻引流,輕度的胸腹腔積液術(shù)后可自行吸收。術(shù)中仔細(xì)觀察、減低灌注液壓力、減少胸腹膜損傷等是防止微通道經(jīng)皮腎鏡取石術(shù)中胸腹腔積液的關(guān)鍵。
[Abstract]:Objective: to investigate the diagnosis and management of microchannel percutaneous nephrolithotomy in the treatment of renal calculi complicated with hydrothorax and peritoneal effusion. Methods: from April 2008 to April 2013, 320 patients with renal calculi underwent percutaneous nephrolithotomy. The data of 10 patients with intraoperative hydrothorax and peritoneal effusion were analyzed retrospectively. Results: there were 8 males and 2 females with a mean age of 39.5 years (31 ~ 59 years). There were 7 cases of left kidney stone and 3 cases of right side kidney stone. The size of stone was 1.0cm 脳 2.0cm 脳 2.5cm~1.8cm 脳 2.5cm 脳 4.0 cm, which was cast stone, and mild hydronephrosis occurred in 3 cases. Six cases of mild pleural and peritoneal effusion, 2 cases of severe hydrothorax and celiac effusion, 2 cases of mild pleural and peritoneal effusion and 2 cases of mild pleural and celiac effusion were found under B-ultrasound localization through the 11th intercostal or 12 subcostal puncture. Abdominal drainage and conservative treatment were cured. The incidence of hydrothorax and celiac effusion was 3.1% (10 / 320) in patients with renal calculi treated by percutaneous nephrolithotomy. 9 cases were followed up for 3 months and 1 case had no improvement in renal function. Conclusion: microchannel percutaneous nephrolithotomy in the treatment of renal calculi can be accompanied by hydrothorax and peritoneal effusion, and the intraoperative B-ultrasound examination can be clearly diagnosed, the severe hydrothorax and peritoneal effusion must be drained immediately and the mild hydrothorax and celiac effusion can be absorbed by itself after operation. Careful observation during operation, reduction of perfusion fluid pressure and reduction of pleural injury are the key to prevent hydrothorax and peritoneal effusion during microchannel percutaneous nephrolithotomy.
【學(xué)位授予單位】：瀘州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R692.4

【共引文獻(xiàn)】

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