微创经皮肾镜取石术治疗肾结石疗效评价(1)
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[摘要] 目的：探讨微创经皮肾镜取石术(MPCNL)治疗肾结石的方法与治疗效果。方法：回顾性分析145例采用MPCNL治疗的肾结石患者资料，男83例，女62例, 平均年龄(59.34±17.63)岁。其中，单纯肾盂结石53例，单纯肾盏结石42例，肾盏和肾盂多发性结石19例，肾铸形或鹿角形结石31例。双肾结石79例。结石大小1.5 cm×2.5 cm～4.5 cm×5.5 cm，平均1.9 cm×2.8 cm。结果：121例行一期穿刺取石，24例行二期取石；124例患者结石取净，结石取净率为85.52%(124/145)。单通道取石111例，双通道取石25例，三通道取石9例。平均手术时间(123.5±26.5) min，平均住院时间14 d。本组患者中有13例术中、术后明显出血，经输血、抗感染等保守治疗后治愈，其余未见严重并发症。结论：MPCNL疗效肯定，具有安全、实用、损伤小、并发症少、恢复快等优点。
[关键词] 微创经皮肾镜取石术；肾结石；肾盂；肾盏
[中图分类号] R692.4 [文献标识码]A[文章编号]1674-4721(2011)04(b)-019-02
Clinical analysis of treament of kidney calculi with minimally invasive percutaneous nephrolithotomy
GAO Yang
The Second People′s Hospital of Deyang City, Sichuan Province, Deyang 618000, China
[Abstract] Objective: To evaluate the feasibility and efficacy of percutaneous nephrolithotomy (MPCNL) in treating renal calculi. Methods: The data of 145 patients with renal calculi who had undergone MPCNL were retrospectively analyzed. There were 83 men and 62 women. The mean age was (59.34±17.63) years. Of the 145 cases, 53 had pelvic calculi, 42 had calyx calculi, 19 had pelvocalyceal calculi, 31 had staghorn calculi, and 79 had bilateral renal calculi. The mean stone size was 1.9 cm×2.8 cm (ranged from 1.5 cm×2.5 cm to 4.5 cm×5.5 cm). Results: Of the 145 cases, 121 underwent one stage MPCNL, and 24 two-stage MPCNL. The procedure was performed by single tract in 111 cases, by two tracts in 25 cases, and by three tracts in 9 cases. The mean operative time was (123.5±26.5) min, and mean hospital stay was 14 days. The total stone clearance rate was 85.52% (124/145). 13 cases experienced bleeding at and were cured by conservative treatment such as blood transfusion and anti-inflammation. No major complications were observed in other patients. Conclusion: MPCNL is effective, it has the advantage of safe and preactical, less damage, rapid recovery and less complication.
[Key words] MPCNL; Kidney calculi; Renal pelvis; Renal lamp
微创经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy, MPCNL)是治疗肾结石的主要手术方法，只需用一根纤细的穿刺针直接从背部进入肾脏，通过直径只有0.7 cm左右的小洞口，用体内碎石机等设备将结石打碎后夹出，具有结石清除率高、恢复快、损伤小、出血少、并发症低等特点[1]。本院2006年1月～2010年9月共行MPCNL 145例 ......
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