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Перкутанная нефролитотомия коралловидных камней: технические особенности и осложнения

Перкутанная нефролитотомия коралловидных камней: технические особенности и осложнения

Abstract

Самой сложной для лечения нозологической формой мочекаменной болезни являются коралловидные конкременты. При этом основным методом лечения больных является перкутанная нефролитотомия. 120 пациентам с коралловидным нефролитиазом выполнена перкутанная нефролитотомия в позиции пациента лежа на животе: под спинномозговой анестезией в 91,7% случаев, в 8,3% случаев – под эпидуральной анестезией. Пункцию чашечек осуществляли под УЗ-наведением, при помощи ретроградного контрастирования полостной системы почки и по анатомическим ориентирам под Rнаведением. Выявлены отрицательные и положительные моменты при использовании нефроскопа системы «Iglesias» в сравнении с использованием дилятаторов «Аmplats». Проанализированы интраи послеоперационные осложнения. Отмечено, что рациональный подход в лечении коралловидного нефролитиаза позволил восстановить адекватный пассаж мочи у всех пациентов, а в 73,3% случаев полностью излечить данную категорию больных.

Staghorn calculi are the most difficultly treated disorders of nosological urolithiasis forms. The main surgical treatment method for this disease is percutaneous nephrolithotomy. 120 patients with staghorn nephrolithiasis underwent percutaneous nephrolithotomy in the prone position of the patient. Spinal anesthesia was used in 91.7% of cases, in 8.3% epidural anesthesia was used. Puncture of the renal pelvis of the kidney was performed under ultrasound guidance, with retrograde contrasting of the renal pelvis and according to R-guided anatomical points. The study determined both negative and positive aspects of nephroscope systems of «Iglesias» compared with the use of dilators «Amplats». Intraand postoperative complications have been analyzed. It is noted that a rational approach in the treatment of staghorn calculus makes it possible to restore an adequate passage of urine in all patients and in73.3% to cure these patients completely.

Keywords

ПЕРКУТАННАЯ НЕФРОЛИТОТОМИЯ, КОРАЛЛОВИДНЫЙ НЕФРОЛИТИАЗ, ОСЛОЖНЕНИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average