微创经皮肾镜取石术治疗孤立肾结石的疗效分析  

Minimally invasive percutaneous nephrolithotomy for renal calculi in solitary kidneys

作　　者：曾国华[1] 钟文[1] 陈文忠[1] 吴文起[1] 袁坚[1] 李逊[1] 吴开俊[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心泌尿外科, 510230

出　　处：《中华泌尿外科杂志》2011年第1期14-16,共3页Chinese Journal of Urology

摘　　要：目的探讨微创经皮肾取石术（MPCNL）治疗孤立肾结石的临床疗效。方法2000年8月至2010年8月，242例孤立肾结石患者接受MPCNI。治疗。GFR17～108ml／min。SCr（108±20）μmol／L，高于正常者19例，平均（181±32）μmol／L。结石位于左侧116例，右侧126例，合并输尿管结石15例。结石大小1．1cm×1．8cm～3．9cm×5．8cm。结果平均手术时间68min。一期结石清除率79．3％（192／242），残留结石≤4mm者16例，残留结石5～19mm者34例。二期MPCNI。及ESWI。术后1个月复查，结石总清除率88．0％（213／242）。术后发热18例，输血21例，因术后严重出血行肾动脉造影及肾出血动脉超选择栓塞治疗10例，肾周血肿1例，气胸1例。结论MPCNL治疗孤立肾结石创伤小、并发症少、结石清除率高，应作为孤立。肾结石患者的首选治疗方案之一。Objective To report our experience with minimally invasive percutaneous nephrolithotomy （MPCNL） in treatment of renal calculi in solitary kidneys. Methods From August 2000 to August 2010, 242 patients with renal calculi in solitary kidneys were treated by MPCNL, the data were reviewed retrospectiveiy. Results The mean operative time was 68 rain, the clearance rates were 79. 3% （192/242） after first session and 88. 0% （213/242） after secon＆look MPCNL and ESWL, respectively. Postoperative fever happened in 18 cases. Twenty one cases required transfu- sion, 10 cases received angiography and embolization. One case experienced perirenal hematoma and 1 case had pneumatothorax. Conclusions MPCNL has the advantages of less bleeding, high clearance rate and short hospital stay. MPCNL is an effective and feasible treatment option for renal calculi in solitary kidneys and should be the first line choice.

关 键 词：肾造口术 经皮 孤立肾 肾结石 并发症 

分 类 号：R699.2[医药卫生—泌尿科学]