Complications Affecting Factors And Countermeasures Of Treatment Kidney Stones Of Percutaneous Nephrolithotomy Under B Ultrasound-guided

Objective: After1976Femstram use percutaneous nephrolithotomy lithotripsy(PCNL) successful treatment of kidney stones, PCNL began to be widely used. Thecountry from1998made Chinese characteristics of B ultrasound-guided percutaneousnephrolithotomy surgery, and gradually across the country applications, so thatpercutaneous nephrolithotomy technology, expanding the scope to adapt. AlthoughPCNL safety has been widely verified, Significantly fewer complications compared toopen surgery and low severity. But as an invasive operation, PCNL broughtintraoperative and postoperative complications should not be overlooked. Understandthe reasons for complications is an important prerequisite to prevent and reduce theincidence of them. And how to timely treatment of complications that have occurred,and death in patients with life. This topic through Methods A retrospective analysis ofpercutaneous nephrolithotomy lithotripsy B ultrasound-guided treatment of kidneystones complication factors and countermeasures are discussed.Method:1. Tabulated using Excel software, recorded119cases of the clinical data ofpatients with hospital: age, sex, length of stay, stone size, stone location, unilateral/bilateral stones, underlying diseases, preoperative urinary tract infection, urine bacterialculture, preoperative renal function, hydronephrosis volume, blood loss, operation time,single/dual/multi-channel complete the surgery, I of stone clearance rate, theexistence of residual stone and residual stone size, postoperative renal function, fistula, postoperative KUB results, intraoperative and postoperative complications,postoperative stones component analysis. And calculate the corresponding incidence ofcomplications. Also using Excel software searches pubmed number of surgical cases inmore than1000cases reported in the central and personal information drawn into tables.Statistical analysis used to compare the two above conclusion.2. The clinical data of patients in our hospital119cases: age, preoperative urinarytract infection, urine bacterial culture positive, stone size, staghorn calculi, diabetes,surgery for more than90minutes of sex, the existence of hydronephrosis, double kidneystones, statistical history of open surgery, and surgery postoperative complicationsstatistics. Using SPSS20.0software using χ2test, P <0.05indicates a statisticallysignificant result.Results:1Our hospital with serious complications appear basically consistent percentage offoreign statistics. Our hospital119cases underwent percutaneous nephrolithotomyultrasonic lithotripsy patients, the operations were successful, I clearance rate of87.39%(104/119), mean operative time was58.67±29.2minutes, the mean intraoperativeblood loss was70.23±46.77ml. There were eight cases of serious complications,serious complications were seen in all stage I patients to complete stone clearance, therate was6.72%(8/119): Were two cases of severe bleeding; pleural injury in2cases,1case of perfusion fluid extravasation; postoperative bleeding one case the delay;postoperative severe infection in2cases. Postoperative fever (temperature>38℃)35cases, accounting for29.41%, of which between38-39℃21cases, the proportion of17.64%(21/119).12cases between39-40℃, ratio of10.08%(12/119). Two cases isgreater than40℃, the ratio of1.68%(2/119). And fever with mixed stones combinedpreoperative urine culture positive majority. Transfusion seven cases, the ratio was5.88%(7/119). No conversion to open surgical cases, serious kidney complications didnot occur through injury, bowel and abdominal organ injury.2. Factors affecting heat generated statistical analysis showed that the former age,preoperative urinary tract infection, urine culture positive, stone size, staghorn calculi, diabetes, surgery time over90minutes with a statistically significant (P <0.05, a=0.05).The sex, the existence of hydronephrosis, double kidney stones, no significant history ofopen surgery (P>0.05). PCNL complications can see the impact of the risk factors wereage, preoperative urinary tract infection, urine culture positive, stone size, staghorncalculi, diabetes, surgery for more than90minutes.Conclusion:At present, the treatment of kidney stones take PCN, and has a small injury, rapidpostoperative recovery, repeatability, etc. it was quickly accepted, and the presence ofresidual stones after ESWL or ureteroscopy may be processed. However, intraoperativeprone to bleeding, organ damage, infection and other complications after surgery, inorder to make the operation more smoothly and safe conduct, we should make theprevention and proper treatment of various complications. B-skilled surgeon shipped tolocate and select the appropriate channel to reduce bleeding puncture; good ultrasoniclithotripsy stone clearance system (EMS), crushed stone at the same time can suck outthe residual stone, and can suck out the vision vacuum outside gravel slag, stones cansignificantly shorten the processing time, improve the operation efficiency;perioperative rational use of antibiotics can be effective in preventing infection,reducing the incidence of postoperative fever. Strictly surgical indications premise is toreduce complications, another learning curve to follow the law, to improve the level ofminimally invasive surgeon is the key to reducing complications guarantee.