经皮方法治疗憩室内结石（19例肾盏憩室）

[Treatment of intradiverticular lithiasis by percutaneous methods (19 caliceal diverticuli)].

作者信息

Lagha K, Martin X, Cuzin B, Gelet A, Maréchal J M, Desmettre O, Dubernard J M

机构信息

Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon.

出版信息

Prog Urol. 1993 Dec;3(6):959-63.

PMID:8305938

Abstract

The main technical procedures in percutaneous nephrolithotomy are the direct puncture of the diverticulum (precise puncture may be required to place the tract directly on to the stone), and treatment duration the diverticulum could be coagulated and a large nephrostomy catheter could be left in place two days. No complication was encountered. One patient refused the treatment after unsuccessful puncture. The nephrostomy tube was left open for two days of drainage. Mean hospital stay was 5 days. Three patients required E.S.W.L because of persistent symptoms. One month after treatment 13 of 18 patients intravenous urography showed obliteration of the diverticulum (72%); Three months after 84% (15/18) of our patients were stone free and 94% (17/18) symptom free. Percutaneous nephrolithotomy should be performed for symptomatic patients, it has low complication rate and should be reserved for patients with persistent symptoms after E.S.W.L.

摘要

经皮肾镜取石术的主要技术步骤是直接穿刺憩室（可能需要精确穿刺以便将通道直接置于结石上），治疗期间可对憩室进行凝固，并留置一根大的肾造瘘导管两天。未出现并发症。一名患者穿刺失败后拒绝治疗。肾造瘘管开放引流两天。平均住院时间为5天。3名患者因症状持续需要进行体外冲击波碎石术（ESWL）。治疗1个月后，18例患者中有13例静脉肾盂造影显示憩室消失（72%）；3个月后，84%（15/18）的患者结石清除，94%（17/18）的患者症状消失。对于有症状的患者应行经皮肾镜取石术，其并发症发生率低，应保留给ESWL后仍有持续症状的患者。