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目的 :探讨复杂性肾结石的手术方法 ,以减少术中出血 ,保护肾功能。 方法:对 4 5例巨大鹿角形肾结石患者采用肾窦内肾盂加肾后下段切开治疗。结果:术中不阻断肾血流 ,术中出血量为 12 0～ 35 0 ml,平均 2 10 ml。手术时间平均为 135 min,取石数量多者达 10 5枚 ,结石体积最大为 8.4 cm× 4 .8cm× 3.6 cm。经 2～ 6年随访 ,4 5例病人的患肾功能恢复良好 ,经 B超或 KU B+IVU复查 ,2例有肾内残留小结石 ,直径 <0 .7cm。结论:肾窦内肾盂加肾后下段切开取石术具有操作简单、手术方便、取净率高、术后并发症少、对肾功能影响小等优点 ,是治疗巨大鹿角形肾结石较好的手术方法之一。
Objective: To explore the surgical method of complex nephrolithiasis to reduce intraoperative bleeding and protect renal function. Methods: Forty-five patients with huge antler nephrolithiasis were treated by intrarenal renal pelvis plus renal replacement. Results: Intraoperative blood flow was not blocked. The blood loss was 120 ~ 35 0 ml, with an average of 210 ml. The average operation time was 135 min, the number of stones was more than 105, the largest volume of stones was 8.4 cm × 4 .8 cm × 3.6 cm. After 2 to 6 years of follow-up, 45 cases of patients with good recovery of renal function, the B-ultrasound or KU B + IVU review, 2 cases of small renal residual stones, diameter <0. Conclusion: The renal pelvis plus renal pelvis plus kidney posterior segment lithotomy has the advantages of simple operation, convenient operation, high net acquisition rate, less postoperative complications and little effect on renal function, which is a good treatment for huge antler kidney stones One of the surgical methods.