多通道微创经皮肾镜取石术治疗复杂性肾结石  

Complex renal calculi treatment of multiple channel minimallyinvasive percutaneous nephrolithotomy

作　　者：廖尚范[1] 伊岱旭[1] 杨炳林[1] 郑健忠[1] 黄志明[1] 吴用样[1] 吴宗强[1] 卢东明[1] 

机构地区：[1]福建医科大学附属三明第一医院泌尿外科,365000

出　　处：《中国实用医药》2011年第14期16-17,共2页China Practical Medicine

摘　　要：目的探讨多通道微创经皮肾镜取石术(MPCNL)治疗复杂性肾结石的安全性与有效性。方法经皮肾通道扩张至F14-20,用小口径的输尿管硬镜(通常为F8/F9·8)替代肾镜,采用多通道取石,利用高压灌注泵的脉冲水压,冲出小碎石。结果 23例患者中,18例患者行一期PCNL,5例肾结石合并积脓先行经皮肾穿刺造瘘术,5～7d后行二期PCNL,其中18例取净结石,其余5例术后有少许结石残留,术后结合ESWL术结石基本排出。所有患者采用2～3通道取石。9例患者术后48h内发热,其余未发现严重并发症。结论采用多通道取石可以克服单通道难以取出平行于通道的肾盏结石的缺点,提高结石清除率,减少术中出血,加快结石取出速度。Objective To assess the safety and feasibility of multiple channel minimally invasive percutaneous nephrolithotomy（MPCNL）in treatment of complex renal calculi.Methods The nephropathy was extended to F14 F16 through invasive percutaneous.A small size of ureterscope F8/F9.8 was used to take stones and the crushed stones were pushed out by pulse water pressure.Results Among 23 cases,5 were pretreated by percutaneous nephropancture and treated secondary PCNL The rest 18 cases were treated with first PCNL.One to three tracts were used in all cases There were 18 cases showed stone free after treated with one stage minimally invasive percutaneous nephrolitho tomy Only one case with pyonephrosis suffered from postoperative infect appeared shock while one stage minimally invasive percutaneous nephrolithotomy.No major complications were noted in other patients.Conclusion Minimally invasive percutaneous nephrolithotomy is safe and effective in treating solitary kidney calculi,compared to traditional PCNL It may offer advantages with respect to less invasion and easy recovery.

关 键 词：经皮肾取石术 多通道 复杂性肾结石 

分 类 号：R699[医药卫生—泌尿科学]