Schärfe T, Alken P, Müller S T, Jurincic C, Hohenfellner R
Department of Urology, Medical School, Hohannes Gutenberg University, Mainz, RFA.
Arch Esp Urol. 1990 Apr;43(3):311-8.
In the present study, the authors analyze the radical change in the treatment of complex renal lithiasis. They advocate the use of this combined approach in patients with a large stone mass or those with obstructive problems of the urinary tract. They discuss the contraindications of this technique; i.e., pelvic kidney, septic urinary infections and severe cardiopulmonary disease. From 1983 to June 1988, a total of 5,657 stone patients were treated at their department; 921 were treated by PCNL combined with ESWL. In 92% of the cases, PCNL was successful in removing most of the stone mass. The complications encountered were fever, hemorrhage, colon perforation, stenosis of UPJ post-PCNL and intrathoracic extravasation. Nephrectomy was warranted in 2 cases due to complication.
在本研究中，作者分析了复杂性肾结石治疗方法的彻底变革。他们主张对结石体积大或存在尿路梗阻问题的患者采用这种联合治疗方法。他们讨论了该技术的禁忌症，即盆腔肾、脓毒症性尿路感染和严重心肺疾病。1983年至1988年6月，他们科室共治疗了5657例结石患者；其中921例采用经皮肾镜取石术（PCNL）联合体外冲击波碎石术（ESWL）治疗。在92%的病例中，PCNL成功清除了大部分结石。遇到的并发症有发热、出血、结肠穿孔、PCNL术后肾盂输尿管连接部狭窄和胸腔内渗漏。因并发症，有2例患者需要进行肾切除术。
