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我院泌尿外科成功完成一例肾脏完全铸形结石经皮肾穿刺造瘘钬激光碎石取石术

发布时间:2023-07-17
来源:宜宾市中医医院 0831-5858120
浏览:5612
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完全铸形结石,是肾脏内一种特殊形状的结石,这类结石是泌尿系统结石中“最棘手的石头”。


日前,宜宾市中医医院泌尿外科刘咏松团队成功为一中年男性开展了完全铸形结石经皮肾穿刺造瘘钬激光碎石取石术,清石率达98%,目前患者已康复出院。


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患者男性教师,因“体检发现右肾结石2年”于今年1月入院,腹部CT片示:右肾铸形结石,长径约6.1cm,充满上中下盏。在做好充分评估、术前准备及手术方案的设定后,患者在寒假做了第一次PCNL手术,完成了约40%的结石,因时间原因,未继续行二期清石手术,遂保留体内输尿管支架管,三个月后更换一次。在更换时发现整个支架管上又附着生长结石。


6月初患者放暑假后,再次来我科入院,泌尿外科团队再次认真分析病情,决定为其行经皮肾穿刺造瘘钬激光碎石取石术。在彩超室刘慧团队的加持下,经过4个小时,在极少量出血的情况下将结石以98%清除率顺利完成,术后一周拔除肾造瘘管,患者康复出院。


术后结石成分分析报告为:六水磷酸镁铵、碳酸磷灰石,这类结石属于感染性结石,复发率高,十年复发率约40-50%,预防这种结石复发的重要前提是完全清除结石。


要求患者做到:
1、每日饮水量至少2000ml,保证每日尿量2000ml以上,最好饮用酸性饮料,利于尿液酸化,如青梅果汁、苹果汁、蔓越莓汁等。因该类结石易在碱性尿液中形成,因而不宜饮用碱性饮料,如:橙汁、可乐、浓茶等。
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2、适度运动,有利于微小结石排出,但应防止过度运动导致脱水,尿液浓缩。

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3、控制感染,注意个人卫生,防止尿路感染。
4、避免受凉,特别是避免肾区、膀胱区和足部受凉。
5、定期每三个月复查尿常规和泌尿系彩超等。

肾脏铸形结石一直以来都是泌尿外科的疑难、复杂疾病,困扰临床医师多年。虽然近几年随着医疗技术进步,肾结石治疗已告别过去开刀历史,但残留结石一直未能很好解决,手术主刀医生的经验、方案制定就显得尤其重要。我院泌尿外科经过多年的积累和发展,在该技术领域已较为成熟。

宜宾市中医医院泌尿外科诊疗范围:

泌尿系结石、肿瘤、感染、先天畸形、男性性功能障碍、慢性前列腺炎、女性盆底功能障碍等疾患。

开展经皮肾穿刺造瘘微通道碎石、取石术治疗肾结石;输尿管软镜治疗输尿管上段及肾结石;输尿管硬镜下治疗输尿管中、下段结石;经尿道前列腺及膀胱肿瘤等离子电切术;经尿道前列腺钬激光剜除术;尿道狭窄内切开术;腹腔镜下肾切除、根治性肾切除、肾部分切除术;腹腔镜下肾上腺肿瘤切除术;腹腔镜下肾盂、输尿管肿瘤、膀胱肿瘤、前列腺肿瘤根治性切除术;小儿、成人包皮、包茎门诊快速手术等。


科室将治疗、预防、随访综合施策,努力全程解决病人疾患。

科室与国内多个知名专家团队保持密切联系与合作,让病人享受国内优质医疗服务。


咨询电话:7865669

咨询地址:市中医医院外科大楼 5楼

科主任:刘咏松 电话:13340654419


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org.springframework.web.servlet.view.AbstractView.render(AbstractView.java:303) at org.springframework.web.servlet.DispatcherServlet.render(DispatcherServlet.java:1282) at org.springframework.web.servlet.DispatcherServlet.processDispatchResult(DispatcherServlet.java:1037) at org.springframework.web.servlet.DispatcherServlet.doDispatch(DispatcherServlet.java:980) at org.springframework.web.servlet.DispatcherServlet.doService(DispatcherServlet.java:897) at org.springframework.web.servlet.FrameworkServlet.processRequest(FrameworkServlet.java:970) at org.springframework.web.servlet.FrameworkServlet.doGet(FrameworkServlet.java:861) at javax.servlet.http.HttpServlet.service(HttpServlet.java:635) at org.springframework.web.servlet.FrameworkServlet.service(FrameworkServlet.java:846) at javax.servlet.http.HttpServlet.service(HttpServlet.java:742) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:231) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.tomcat.websocket.server.WsFilter.doFilter(WsFilter.java:52) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.boot.web.filter.ApplicationContextHeaderFilter.doFilterInternal(ApplicationContextHeaderFilter.java:55) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.shiro.web.servlet.AbstractShiroFilter.executeChain(AbstractShiroFilter.java:449) at org.apache.shiro.web.servlet.AbstractShiroFilter$1.call(AbstractShiroFilter.java:365) at org.apache.shiro.subject.support.SubjectCallable.doCall(SubjectCallable.java:90) at org.apache.shiro.subject.support.SubjectCallable.call(SubjectCallable.java:83) at org.apache.shiro.subject.support.DelegatingSubject.execute(DelegatingSubject.java:387) at org.apache.shiro.web.servlet.AbstractShiroFilter.doFilterInternal(AbstractShiroFilter.java:362) at org.apache.shiro.web.servlet.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:125) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.shiro.web.servlet.AdviceFilter.executeChain(AdviceFilter.java:108) at org.apache.shiro.web.servlet.AdviceFilter.doFilterInternal(AdviceFilter.java:137) at org.apache.shiro.web.servlet.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:125) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at com.alibaba.druid.support.http.WebStatFilter.doFilter(WebStatFilter.java:123) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.boot.actuate.trace.WebRequestTraceFilter.doFilterInternal(WebRequestTraceFilter.java:110) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.tuckey.web.filters.urlrewrite.RuleChain.handleRewrite(RuleChain.java:176) at org.tuckey.web.filters.urlrewrite.RuleChain.doRules(RuleChain.java:145) at org.tuckey.web.filters.urlrewrite.UrlRewriter.processRequest(UrlRewriter.java:92) at org.tuckey.web.filters.urlrewrite.UrlRewriteFilter.doFilter(UrlRewriteFilter.java:389) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.web.filter.RequestContextFilter.doFilterInternal(RequestContextFilter.java:99) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.web.filter.HttpPutFormContentFilter.doFilterInternal(HttpPutFormContentFilter.java:105) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.web.filter.HiddenHttpMethodFilter.doFilterInternal(HiddenHttpMethodFilter.java:81) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.web.filter.CharacterEncodingFilter.doFilterInternal(CharacterEncodingFilter.java:197) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.springframework.boot.actuate.autoconfigure.MetricsFilter.doFilterInternal(MetricsFilter.java:106) at org.springframework.web.filter.OncePerRequestFilter.doFilter(OncePerRequestFilter.java:107) at org.apache.catalina.core.ApplicationFilterChain.internalDoFilter(ApplicationFilterChain.java:193) at org.apache.catalina.core.ApplicationFilterChain.doFilter(ApplicationFilterChain.java:166) at org.apache.catalina.core.StandardWrapperValve.invoke(StandardWrapperValve.java:198) at org.apache.catalina.core.StandardContextValve.invoke(StandardContextValve.java:96) at org.apache.catalina.authenticator.AuthenticatorBase.invoke(AuthenticatorBase.java:478) at org.apache.catalina.core.StandardHostValve.invoke(StandardHostValve.java:140) at org.apache.catalina.valves.ErrorReportValve.invoke(ErrorReportValve.java:80) at org.apache.catalina.core.StandardEngineValve.invoke(StandardEngineValve.java:87) at org.apache.catalina.connector.CoyoteAdapter.service(CoyoteAdapter.java:342) at org.apache.coyote.http11.Http11Processor.service(Http11Processor.java:799) at org.apache.coyote.AbstractProcessorLight.process(AbstractProcessorLight.java:66) at org.apache.coyote.AbstractProtocol$ConnectionHandler.process(AbstractProtocol.java:861) at org.apache.tomcat.util.net.NioEndpoint$SocketProcessor.doRun(NioEndpoint.java:1455) at org.apache.tomcat.util.net.SocketProcessorBase.run(SocketProcessorBase.java:49) at java.util.concurrent.ThreadPoolExecutor.runWorker(ThreadPoolExecutor.java:1149) at java.util.concurrent.ThreadPoolExecutor$Worker.run(ThreadPoolExecutor.java:624) at org.apache.tomcat.util.threads.TaskThread$WrappingRunnable.run(TaskThread.java:61) at java.lang.Thread.run(Thread.java:748)