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目的:探讨运用B超引导微创经皮肾镜取石术治疗结石性脓肾的疗效及安全性。方法:对21例结石性脓肾患者采用B超引导下微创经皮肾镜取石术进行治疗,钬激光碎石视情况决定一期或分期治疗,术中留置双J管,1个月后拔除。结果:16例一期取石治疗,5例二期取石治疗,手术过程顺利。1例术后出现感染性休克,及时治疗后好转,无其他严重并发症。结石全部清除或留有4 mm以下残余碎片者17例,肾残留碎石(大于5mm但不影响引流)4例,其中2例行ESWL后结石排出,2例未作特殊处理。随访4～32个月,20例患者肾功能有不同程度恢复,1例因患肾多发脓肿行患肾切除术。结论:B超引导微创经皮肾镜取石术治疗结石性脓肾安全有效,需视术中情况决定一期或分期治疗。
Objective: To explore the use of B-guided minimally invasive percutaneous nephrolithotomy lithotomy in the treatment of pyuric kidney efficacy and safety. Methods: Twenty-one cases of calculous pyogenic kidney were treated by minimally invasive percutaneous nephrolithotomy guided by B-ultrasonography. Holmium laser lithotripsy was determined by one-stage or staged treatment according to the situation. The double J-tube was placed in the operation and one month later removal. Results: Sixteen cases were treated by first stage lithotripsy and five cases were treated by second stage lithotripsy. The procedure was successful. One case of postoperative septic shock, improved after treatment, no other serious complications. Seven patients had residual stones with residual stones less than 4 mm, and 4 patients with residual renal graves (more than 5 mm without affecting drainage). Two of them were discharged after ESWL and two were not treated. After 4 to 32 months of follow-up, the renal function of 20 patients recovered to varying degrees and one patient suffered from nephrectomy due to multiple abscess of the kidney. Conclusion: B-guided minimally invasive percutaneous nephrolithotomy lithotomy for the treatment of pus kidney safe and effective, depending on the circumstances decided to stage or stage treatment.