【摘要】 目的 通过不同术式的比较以提高复杂性肾结石的手术疗效，降低结石的残留率及术后肾功能的恢复。方法 回顾，总结，分析35例复杂性肾结石不同术式手术治疗的临床资料。结果 低温阻断肾动脉肾实质切开取石术组18例动脉阻断时间25～65min，出血量80～400ml，手术时间90～170min。间断性不完全性肾蒂阻断行肾实质切开取石组17例手术病人, 12例手术病人出血少于200ml均未输血,有2例患者术中出血稍多输血400ml,手术取石时间(从上肾蒂钳到肾实质缝合完毕后取肾蒂钳)15～ 25min,平均17.5min。手术取石时间短,平均13.2min,术后患肾功能均正常。结论 对肾窦内肾盂铸型肾结石开放手术治疗需要根据结石的大小、形态、手术所需的时间及难易程度确定术式。低温阻断肾动脉肾实质切开取石术具有出血少、显露充分、术野清晰、结石取净率高等优点。间断不完全性肾蒂阻断下行肾实质切开取石术具有简单、快捷、肾功能损伤小、恢复快等优点。

    【关键词】 肾结石;外科手术

    The exploration of various nephrotomy of removal the stones for the complex nephrolithiasis

    SUN Gui-yang,GAO Jian-bang,WANG Xin.Department of Urologic Surgery,The 208 Hospital of PLA,Changchun,Jilin 130062,China

    【Abstract】 Objective To the purpose of promote the surgical operating effect about complex kidney stone from the comparison of different surgical decrease the remain a rate of kidney stone and the recover the kidney function. Methods Review and analyze the clinic data of 35 cases of the complex kidney stone from different surgical operation method. Results There are 18 examples at operation to cut open the kidney and take stone in the environment to stop kidney artery takes 25～65min. The bleeding quantity is 80～400ml,it is 90～170min to operation.There are 17 examples to cut open the kidney paren chyma and take stone in a environment to interrupted and imperfectly stop the kidney pedicel,there are 12 patients to bleeding of 200ml ......