Combined standard percutaneous nephrolithotomy and 4.8Fr micro- percutaneous nephrolithotomy and for multiple renal calculi (46 cases)
10.3969/j.issn.1007-1989.2017.09.019
- VernacularTitle:可视标准通道联合F4.8可视穿刺超微经皮肾镜在肾多发结石中的应用(附46例报告)
- Author:
Cui ZHEN-YU
1
;
Gao YAN-JUN
;
Yang WEN-ZENG
;
Zhou KE-YI
;
Zhao CHUN-LI
;
Ma TAO
;
Shi XIAO-QIANG
Author Information
1. 河北大学附属医院 泌尿外科
- Keywords:
percutaneous nephrolithotomy;
standard channel;
micro-percutaneous nephrolithotomy;
multiple renal calculi
- From:
China Journal of Endoscopy
2017;23(9):99-102
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.
