微创经皮肾镜取石术治疗肾结石  

作　　者：舒杨柳[1] 郑劲松[1] 邱元林[1] 王祥勇[1] 周斌[1] 杨振林[1] 谢扬科 

机构地区：[1]湖南省洞口县人民医院泌尿外科,422300

出　　处：《当代医学》2010年第20期93-94,共2页Contemporary Medicine

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效果。方法回顾性分析636例采用MPCNL治疗的肾结石患者资料,男391例,女245例。平均年龄43岁。其中单纯肾盂结石75例,单纯肾盏结石117例,肾盂和肾盏多发结石283例,肾铸形或鹿角形结石127例,双侧肾结石34例。结石大小2.0cm×1.0cm～5.0cm×4.5cm,平均3.0cm×2.0cm。结果 611例患者一期取石,25例二期取石。单通道取石549例,双通道取石78例,三通道取石9例。1次取石471例,2次取石122例,3次取石43例。结石清除率83.6%(532/636),平均手术时间90min,平均住院12d.术中均未输血。17例术后并发出血,经输血、抗炎等保守治疗后治愈,3例并发气胸,经胸腔闭式引流术后治愈,其余未见严重并发症。结论 MPCNL具有创伤小、出血小及并以症少等优点,治疗肾结石安全有效,尤其对肾结石再次手术治疗有较大优越性。Objective To evaluate the feasibility and efficacy of percutaneous nephrolithotomy（MPCNL）in treating renal calculi.Methods The data of 636 patients with renal calculi who had undergone MPCNL were retrospectively analyzed.There were 391 men and 245 women.The mean age was 43 years （range,6-72years）,of the 636 cases,75 had pelvic calculi,117 had calyx calculi,283 had pelvocalyceal calculi,127 had staghorn calculi,and 34 had bilateral renal calculi.The mean stone size was 3.0cm×2.0cm（ranged from 2.0cm×1.0cm to 5.0cm×4.5cm）.Results Of the 636 cases,611 underwent one stage MPCNL, and 25,two-stage MPCNL.The procedure was performed by single tract in 549 cases,by two tracts in 78 cases,and by three tracts in 9 cases.Lithotomy was done by one session in 471 cases,by two sessions in 122 cases,and by three sessions in 43 cases.The total stone clearance rate was 83.6%.The mean operative time was 90 min,and mean hospital stay was 12d.NO blood transfusion was needed during operation,17 cases experienced bleeding at and were cured by conservative treatment such as blood transfusion and anti-inflammation,and 3 cases had pneumothorax and were cured by closed thoracic drainage.No major complications were observed in other patients.Conclusion MPCNL has advantages of minimal trauma,less blood loss,fewer complications,and is safe and effective in treating renalcalculi,especially for patients who will have the second procedure.

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]