经皮肾镜碎石术及其相关并发症研究进展

摘要/Abstract

摘要： 通过pubmed搜索手术例数超过千例以上的中心及个人报道相关资料,对其手术经验、手术并发症等方面进行详细记载及讨论.经皮肾镜手术并发症的总发病率约为83%,主要包括尿液外渗(7.2%)、出血(11.2%~17.5%)以及发热(21.0%~32.1%).然而,严重并发症,如败血症(0.3%~4.7%)以及结肠(0.2%~0.8%)或胸膜损伤(0~3.1%)非常罕见.结石合并其他疾病时(如肾功能不全、糖尿病、明显肥胖、肺部疾病)增加了手术并发症的发生率.大多数并发症(如出血、尿外渗、发热)可通过保守治疗或微创治疗(如胸腔引流、超选择性肾动脉栓塞)而治愈.对于预防经皮肾镜手术并发症来讲,最重要的是病例的选择、成熟的手术步骤以及术后的密切随访.

关键词: 手术并发症, 内镜手术, 经皮肾镜, 肾结石

Abstract: Based on institutional and personal experience in more than 1 000 patients treated by PCNL, we reviewed the literature (Pubmed search) focusing on technique, type, and incidence of complications of the procedure. Complications during or after PCNL may be present with an overall complication rate of up to 83%, including extravasation (7.2%), transfusion (11.2%–17.5%), and fever (21.0%–32.1%), whereas major complications, such as septicaemia (0.3%–4.7%) and colonic (0.2%–0.8%) or pleural injury (0–3.1%) were rare. Comorbidity (i.e., renal insufficiency, diabetes, gross obesity, pulmonary disease) increased the risk of complications.Most complications (i.e., bleeding, extravasation, fever) could be managed conservatively or minimally invasively (i.e., pleural drain, superselective renal embolisation) if recognised early. The most important consideration for achieving consistently successful outcomes in PCNL with minimal major complications were the correct selection of patients, a well-standardised technique and postoperative follow-up.

Key words: complications, endourology, percutaneous nephrolithotomy, Urinary calculi

中图分类号:

杨文增,郭景阳. 经皮肾镜碎石术及其相关并发症研究进展[J]. 医学研究与教育, 2013, 30(1): 81-86.

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