微创经皮肾镜取石术治疗复杂性肾结石65例  

Treatment of complex renal stone with minimally invasive percutaneous nephrolithotomy (Report of 65 cases)

作　　者：王卫峰[1] 米其武[1] 张志刚[1] 刘绍虔[1] 罗杰鑫[1] 张增强[1] 

机构地区：[1]东莞市人民医院泌尿外科,523000

出　　处：《中华腔镜泌尿外科杂志（电子版）》2009年第2期19-21,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨微创经皮肾镜(MPCNL)治疗复杂性肾结石的手术安全性和效果。方法采用MPCNL治疗复杂性肾结石65例,男48例,女17例。年龄20～68岁,平均45岁。KUB测量结石最大径2.0～7.3cm,平均3.5cm。超声显示32例肾积水。在X线下穿刺并建立16F经皮肾通道,肾镜下采用气压弹道碎石取石。结果一次性取净结石43例,二次性取净结石22例,结石总取净率达85%。手术平均时间100min(60～180min),术中出血量平均200ml。6例术后严重出血给予输血。一次性取石患者平均住院时间8d(6～14d)。术后肾功能及肾积水情况较术前改善。35例出院后获随访2～13个月,均无严重出血和感染。结论MPCNL是治疗复杂性肾结石的一种简便、安全、有效的方法,但应重视其并发症的防治,严格掌握手术指征。Objectives To evaluate the clinical effect and safety of minimally invasive percutaneous nephrolithotomy（MPCNL） for complicated renal stone. Methods A total of 65 patients（48 males,17 females, age 20--68 years） with complicated renal stone were treated with MPCNL The mean stone diameter was 3.5 cm （range 2.0-7.3 cm）. The kidney was punctured under X-ray guiding the way. An F16 working channel was dilated, percutaneous nephrolithotomy were used for treatment. Results 43 cases were cleared by once, the total stone clearance rate was 85%. The average operative time was 100 min （range 60-180 min）. Mean estimated blood loss was 200 ml （range 50-500 ml）. 6 cases had severe hemorrhage postoperatively . Follow-up of 2 to 13 months follow-up for 35 cases showed good results. Mean hospital stay was 8 days （range 6-14 d）. Conclusions Under the guide of X-ray, MPCNL for renal stone has advantages of less trauma, fewer complications, and quicker recovery. It is worthy of widespread application. It is simply, safe and effective for managing complicated renal stone. But the prevention of complications should be emphasized.

关 键 词：微创经皮肾镜 取石术 肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]