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Sixty-six cases of bilateral upper urinary tract stones are reported and the treatment of the stone complieation, acute oliguria, chronic uremia, partial nephrectomy and staghorn calculus are discussed. If the bilateral upper urinary tract stones couldn't be extracted of themselves, the operation was not complicated. The patients' conditions were well. An operation is introduced here. 本文报告66例双侧上尿路结石治疗情况。讨论了结石合并急性尿闭,慢性尿毒症,肾部分切除术及鹿角形结石的处理等问题。双侧上尿路结石,如结石不能自行排出,手术不太复杂,病人情况良好,推荐一次手术摘除双侧结石。 Purpose:To study the curative effect of nephrolithoto my at the posterior basal segment for staghorn calculus and other complex calculus of kidney.Methods:We applied nephrolithotomy at the posterior basal segment for complex neophrolithiasis in 31 cases.Results:8 cases needed intraoperative blood transfusion and the mean amount of blood was 116 ml.Three weeks postoperatively KUB & IVU indicated normal kidney development,improved hydronephrosis,no intrarenal and extrarenal stricture.Single-time clearance... Purpose:To study the curative effect of nephrolithoto my at the posterior basal segment for staghorn calculus and other complex calculus of kidney.Methods:We applied nephrolithotomy at the posterior basal segment for complex neophrolithiasis in 31 cases.Results:8 cases needed intraoperative blood transfusion and the mean amount of blood was 116 ml.Three weeks postoperatively KUB & IVU indicated normal kidney development,improved hydronephrosis,no intrarenal and extrarenal stricture.Single-time clearance in 26 cases and remanent calculus in 5 cases,in which 4 case were cured by ESWL and 1 case discharged by self.Conclusions:Nephrolithotomy at the posterior basal segment has the advantages of little intraoperative bleeding,high single-time clearance rate,slight impairment of renal function,little damage of renal collecting system and it is favorable for the operative treatment for the remanent calculus.This method is suitable for intrarenal staghorn and other complex pyelolithiasis with multiple calyceal calculus. 目的 :探讨肾后基段间区切开取石术治疗复杂性肾鹿角状或铸状结石的疗效。方法 :应用肾后基段间区切开取石术治疗复杂性肾鹿角状或铸状结石 31例。结果 :术中输血 8例、平均输血1 1 6ml;术后 3周 KUB加 IVU复查 ,肾脏显影正常 ,积水减少 ,无肾内外狭窄 ;结石一次性取净2 6例 ,残余结石 5例 ,其中 4例经 ESWL治愈 ,1例结石自然排净。结论 :肾后基段间区切开取石术具有术中出血少、结石一次性取净率高、肾集合系统破坏小、肾功能受损轻及便于处理残余结石等优点。适合于肾内型肾盂鹿角状或铸状结石并发肾盏多发性结石的治疗。 Objective To analyse the ultrasonography of staghorn calculus and pile up multiple nephrolithiasis in isolated pig ren in order to avoid the misdiagnosis of staghorn calculus. Methods (1) Preliminary test was performed in isolated pig ren with fresh pork wrapped. (2) A staghorn calculus (the most large diameter>2.4 cm) and four nephrolithiasis (the most large diameter<1 cm were selected, we changed their situation four times, then put them into different pig renal pelvis respectively.... Objective To analyse the ultrasonography of staghorn calculus and pile up multiple nephrolithiasis in isolated pig ren in order to avoid the misdiagnosis of staghorn calculus. Methods (1) Preliminary test was performed in isolated pig ren with fresh pork wrapped. (2) A staghorn calculus (the most large diameter>2.4 cm) and four nephrolithiasis (the most large diameter<1 cm were selected, we changed their situation four times, then put them into different pig renal pelvis respectively. The ultrasonography was examined with ultrasonic. (3) While the isolated pig ren dissected, we compare the ultrasonography of staghorn calculus with the one of pile up multiple nephrolithiasis in shape. Results (1) The preliminary test show: The ultrasonography of the isolated pig ren equal to the one of people ren. (2) In the ultrasonography of the staghorn calculus and pile up multiple nephrolithiasis on isolated pig ren, the identical character is the strength echo light image and posterior sonagram of clustering multiple, discontinual and malposition. (3) In the ultrasonography of the staghorn calculus and pile up multiple nephrolithiasis on isolated pig ren, the different character show the most width strength echo light image of single staghorn calculus≥1 cm. It's posterior shadow is width, definition and continuation of multiple shadows. The most width strength echo light image of single pile up multiple nephrolithiasis<1 cm. It's posterior shadow is stenosis, dark and dislcoutinuation of multiple shadows. (4) The ultrosonography of staghorn calculus and pile up multipl nephrolithiasis in isolated pig ren is different with their different situation. Ultrasonic examination can't show the shape of nephrolithiasis, but it can show the most large diameter and the most width strehgth eacho image of them on isolated pig ren exactly. Conclusion Ultyrosonic examination of multiple section may show the different ultrasonography of staghorn calculus and pile up multiple nephrolithiasis on isolated pig ren. While clinical ultrasonic examination on staghorn calculus, the misdiagnosis will be avoided. 目的 观察分析鹿角形及堆积的多发性人肾结石在离体猪肾中的声像图表现 ,以期为临床超声减少对鹿角形肾结石的误诊与误导。方法 (1 )用新鲜猪肉包裹离体猪肾建立模型。 (2 )选取从人肾中取出的 1枚最大径 2 .4cm的鹿角形结石及 4枚最大径 <1cm的小结石 ,改变鹿角形结石方位、小结石堆积的形态 5次 ,用镊子分别送入不同的猪肾盂内 ,进行超声检查 ,观察声像图表现。 (3 )剖开离体猪肾 ,将鹿角形结石及堆积的多发性人肾结石在离体猪肾盂内的形态、大小与其声像图进行对比分析。结果 (1 )离体猪肾声像图与活体人肾声像图极相似。 (2 )鹿角形及堆积的多发性肾结石在离体猪肾中声像图相同点为 :聚集成一团的、多个大小不一、断续、参差、错位的强回声光团 ,后伴声影。 (3 )鹿角形及堆积的多发性结石声像图不同点为 :鹿角形结石声像图中单个最宽强回声≥ 1cm ,其后声影宽、明显 ,多个声影间连续 ;堆积的多发性结石声像图中单个最宽强回声 <1cm ,其后声影窄、弱 ,多个声影间不连续。 (4 )声像图随小结石堆积的形态、鹿角形结石的方位均有不同的表现 ,超声能较准确地测量结石最大径及单个最宽强回声大小 ,但... 目的 观察分析鹿角形及堆积的多发性人肾结石在离体猪肾中的声像图表现 ,以期为临床超声减少对鹿角形肾结石的误诊与误导。方法 (1 )用新鲜猪肉包裹离体猪肾建立模型。 (2 )选取从人肾中取出的 1枚最大径 2 .4cm的鹿角形结石及 4枚最大径 <1cm的小结石 ,改变鹿角形结石方位、小结石堆积的形态 5次 ,用镊子分别送入不同的猪肾盂内 ,进行超声检查 ,观察声像图表现。 (3 )剖开离体猪肾 ,将鹿角形结石及堆积的多发性人肾结石在离体猪肾盂内的形态、大小与其声像图进行对比分析。结果 (1 )离体猪肾声像图与活体人肾声像图极相似。 (2 )鹿角形及堆积的多发性肾结石在离体猪肾中声像图相同点为 :聚集成一团的、多个大小不一、断续、参差、错位的强回声光团 ,后伴声影。 (3 )鹿角形及堆积的多发性结石声像图不同点为 :鹿角形结石声像图中单个最宽强回声≥ 1cm ,其后声影宽、明显 ,多个声影间连续 ;堆积的多发性结石声像图中单个最宽强回声 <1cm ,其后声影窄、弱 ,多个声影间不连续。 (4 )声像图随小结石堆积的形态、鹿角形结石的方位均有不同的表现 ,超声能较准确地测量结石最大径及单个最宽强回声大小 ,但不能准确推测结石的形态。结论 多切面超声检查可显示出鹿角形及堆积的多发性人肾结石在离体猪肾中?
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