基层医院开展经皮肾穿刺微造瘘输尿管镜碎石取石术治疗肾结石的初步体会  

The grass-roots hospital mini-percutaneous nephrolithotomy in the treatment of hydronephrotic renal calculi

作　　者：练文勇[1] 汪利明[1] 贾延顺[1] 曹凡[1] 马大东[1] 徐火松[1] 王勤章[2] 

机构地区：[1]新疆兵团农一师医院泌尿外科,新疆阿克苏843000 [2]石河子大学医学院第一附属医院泌尿外科,新疆石河子832008

出　　处：《农垦医学》2009年第3期229-231,共3页Journal of Nongken Medicine

基　　金：兵团政策引导类科技计划基金(2007JD14)

摘　　要：目的:探讨基层医院开展经皮肾穿刺微造瘘输尿管镜碎石取石术(mini-PCNL)治疗肾结石的手术技巧及临床应用价值。方法:回顾性分析12例肾结石患者采用mini-PCNL术治疗的临床资料。12例肾结石均为单侧,结石长径2.2～5.4cm。在C臂X光机或B超定位引导下穿刺,建立皮肾工作通道后用气压弹道碎石机或联合U100plus激光碎石。结果:12例患者均一期成功建立工作通道并取石,手术时间40～140min,平均70min。术中出血50～200mL。10例一期取净结石,1例二期取尽结石,仅1例有少许结石残留,术后予以体外震波碎石治疗。随访4～12月,12例均无肾积水及盂管交界处狭窄。结论:基层医院在严格把握手术适应症的前提下,开展mini-PCNL治疗肾结石具有创伤小、安全、痛苦少、恢复快、疗效好等优点,是治疗肾结石的好方法。Objective： To evaluate the surgical techniques and clinical effects of mini-percutaneous nephrolithotomy （mini-PCNL） in the treatment of unhydronephrotic renal calculi at the grass-roots hospital. Methods： The clinical data of 12 cases treated by mini-PCNL were retrospectively analyzed. There were mono-renal caculi in 12 patients. The diameter of calculi ranged from 2.2 to 5.4 cm. Puncturation was guided by B-type ultrasound and / or x-ray. Lithotripsy by airpressure path lithotripter and/or U100plus laser was done when the pervium was established： Results：The pervium in the 12 patients was successfully established by one -session puncturation. The operative time ranged from 40 to 140min（ mean = 70min）. The amount of blood ranged from 50 to 200mL and no one needed blood transfusion. Calculus was completely removed in 10 patients. 1 cases were completely removed by second-look mini-PCNL. Leftover calculi in 1 patients were treated by extracorporeal shock-wave lithotripy （ESWL）. All the 12 patients were followed up for 4 to 12 months. None of them had nephrohydrops or stenosis. Conclusion：The grass-roots hospital under the premise that strictly holds surgical operation, Percutanepy pneumatic lithotripsy and U100-puls laser lithotripsy for hydronephrotic renal stone have the adventags of high efectiveness, safety and rapid recovery, less suffering. It＇s a good methods in treatment of hydronephrotic renal stone.

关 键 词：经皮肾穿刺微造瘘取石术 肾结石 肾积水 

分 类 号：R692.4[医药卫生—泌尿科学]