Zhou Da-Qing, Wang Jian, Li Wen-Gang, Pang Xiang, Liu Shang-Wen, Yu Xiao-Xiang, Jiang Bo
Department of Urology, 303 Hospital of PLA, Nanning 530021, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2009 Jul;29(7):1417-9.
To investigate the feasibility of treatment for calculous pyonephrosis with first stage percutaneous nephrolithotomy under the standard access.
Thirty-six cases of calculous pyonephrosis and 36 cases of urolithiasis with no pyonephrosis were treated by percutaneous nephrolithotomy. In the nephrostomy, the caliber was dilated to F24. All the operations were preformed through the EMS lithotrity system. The intrapelvic pressure was detected in the operation. The hemoculture before and after operation, the germi culture of urine, and the temperature and blood leucocyte changes after operation were recorded. All the patients were treated by antibiotics before and after the operation.
All the patients were treated successfully. The average intrapelvic pressure were 23.2 cmH(2)O in non-pyonephrosis group and 22.8 cmH(2)O in pyonephrosis group. Both of the groups had 1 case of transient bacteremia after the operation. No significant difference was found in the other indices between the two groups.
EMS lithotrity system is safe and feasible for treating calculous pyonephrosis with stage I percutaneous nephrolithotomy via the standard access.
探讨在标准通道下一期经皮肾镜取石术治疗结石性脓肾的可行性。
对36例结石性脓肾患者和36例无脓肾的尿路结石患者行经皮肾镜取石术。在肾造瘘时，将通道扩张至F24。所有手术均通过EMS碎石系统进行。术中检测肾盂内压力。记录手术前后的血培养、尿液细菌培养以及术后体温和血白细胞变化。所有患者在手术前后均接受抗生素治疗。
所有患者均治疗成功。非脓肾组平均肾盂内压力为23.2 cmH₂O，脓肾组为22.8 cmH₂O。两组术后均有1例发生短暂菌血症。两组其他指标比较差异无统计学意义。
EMS碎石系统经标准通道一期经皮肾镜取石术治疗结石性脓肾安全可行。
