高甘油三酯血症性急性胰腺炎（hypertriglyceridemia-induced acute pancreatitis, HTG-AP）因"诱因隐匿、淀粉酶升高不明显、发病年轻化、合并症多、病情进展快、易重症化"给临床救治带来困难。快速降低甘油三酯水平是逆转病情进展和治疗的关键。本文报道病因隐匿的急性胰腺炎（acute pancreatitis, AP）治疗成功案例1例，旨在对HTG-AP早期识别和病因治疗提供临床经验。

Objective:To investigate how to handle renal pedicle and its effect for retroperitoneal laparoscopic nephrectomy(RLN).Methods:A total of 34 patients underwent RLN during May 2011 to October 2014 in our hospital.The technique of handling renal pedicle was critically summarized and the clinical and perioperative data were retrospectively studied.Results:A total of 33 successful RLNs and 1 conversion to open surgery due to severe adhesion around sarcoma renal pedicle were carried out.All the operations were successfully performed,with a mean operation time of 117.2 min (80-245 min) and a mean time of 28 min (12-50 min) for looking for renal pedicle.The mean estimated blood loss was 156 mL (30-900 mL).Three blood transfusions were needed during surgery,and postoperative small artery bleeding occurred in one case because of sudden blood pressure increase and became stable in 11 days.Conclusions:Handling renal pedicle is the key step of RLN.It is safe and effective to be familiar with retroperitoneal anatomy and the rational strategy to handle renal hilum vessels.

目的探讨微创经皮肾镜取石术治疗肾结石的疗效。方法选取96例肾结石患者作为研究对象，其中48例患者采取微创经皮肾镜取石术治疗，作为观察组；另外48例患者采取开放手术治疗，作为对照组；对比两组患者的手术时间、术中出血量、住院时间、造瘘管留置时间及进流质时间，根据结石清除率，综合评价患者的疗效，并作对比分析。结果观察组手术时间为(56.27±7.42)min、术中出血量为(88.76±13.25)ml、住院时间为(6.54±0.82)d、造瘘管留置时间为(4.74±0.43)d、进流质时间为(33.82±7.63)h，对照组手术时间为(89.35±16.38)min、术中出血量为(178.31±20.05)ml、住院时间为(14.47±2.42)d、造瘘管留置时间为(13.23±2.58)d、进流质时间为(56.79±11.52)h；两组数据具有显著性差异(<0.05)；观察组结石清除率为91.67%，对照组结石清除率为93.75%；两组数据无显著性差异(>0.05)。结论微创经皮肾镜取石术治疗肾结石的结石清除效果与开放手术相当，但微创经皮肾镜取石术的手术创伤性小、术后恢复快，预后良好，可作为肾结石的理想治疗方法之一。

目的:探讨下尿路梗阻引起肾功能不全患者腔内治疗的方法及疗效。方法:回顾性分析58例下尿路梗阻引起肾功能不全患者临床资料,所有患者均经B超、腹部平片(KUB)、静脉肾盂造影(IVP)及实验室检查证实。随机分为两组,其中观察组28例采用经尿道前列腺电切术(TURP)行腔内治疗,对照组30例采用传统的开放性手术治疗。观察比较两组疗效、肾功能恢复及3年肌酐清除率情况。结果:本组58例下尿路梗阻引起肾功能不全患者均一次手术成功,无一例中途转行其他手术。其中观察组术中出血量65mL,平均手术时间50min,术后平均留置尿管时间5.2h,术后平均住院时间6天;对照组术中出血量104mL,平均手术时间80min,术后平均留置尿管时间3天,术后平均住院时间14天。观察组疗效显著优于对照组(P<0.05);两组术中及术后均无明显大出血、尿外渗、尿道穿孔、水中毒、直肠损伤等情况发生。经术后2～12个月随访,两组患者的生活质量、前列腺症状及剩余尿量较术前均明显改善,最大尿流率明显增加(P<0.05)。观察组预后显著优于对照组(P<0.05)。结论:经尿道前列腺电切术(TURP)具有疗效显著、创伤小、并发症少、安全性高、可重复、操作简易等特点,是治疗下尿路梗阻引起肾功能不全一种安全而有效的方法,值得临床推广应用。