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目的探讨微创经皮肾镜取石术(MPCNL)后常规放置肾造瘘管的必要性。方法56例肾结石患者,MPCNL中无严重的出血或并发症且无需行二期MPCNL,对其术后不放置肾造瘘管的可行性进行分析。结果56例患者中,MPCNL结石清除率87.5%(49/56);7例(12.5%)结石残留;经体外冲击波碎石(ESWL)结石排净,结石总清除率100%。平均手术时间45 m in,平均血红蛋白水平下降14.2 g/L(5~38 g/L)。2例患者术后输血400 m l。15例患者术后给予哌替啶75 mg。平均住院时间3天,无大出血、漏尿及邻近器官损伤等并发症发生。结论MPCNL术后常规放置肾造瘘管是不必要的,部分非复杂性MPCNL术后不放置造瘘管能够减少术后止痛剂的使用,缩短住院天数。
Objective To investigate the necessity of routine nephrostomy after minimally invasive percutaneous nephrolithotomy (MPCNL). Methods Fifty - six patients with renal calculi without MPCNL had severe bleeding or complications without MPCNL. The feasibility of no postoperative nephrostomy was analyzed. Results 56 cases of patients, MPCNL stone clearance rate of 87.5% (49/56); 7 cases (12.5%) stone residue; extra-shock wave lithotripsy (ESWL) stones row net, total stone clearance rate of 100%. The average operative time was 45 mins, and the mean hemoglobin level was 14.2 g / L (5 ~ 38 g / L). Two patients had a blood transfusion of 400 ml after surgery. Fifteen patients received pethidine 75 mg postoperatively. The average length of hospital stay was 3 days, with no major bleeding, leakage of urine, and complications of adjacent organs. Conclusion Conventional placement of nephrostomy tube after MPCNL is unnecessary. Partial noncomplex MPCNL after operation can reduce the use of analgesics and shorten the length of hospital stay.