微通道经皮肾镜取石术用于不同类型肾结石的临床应用进展  

Progress in the clinical application of miniaturized percutaneous nephrolithotomy for different types of kidney stones

作　　者：熊庄 程帆[1] XIONG Zhuang;CHENG Fan(Department of Urology,Renmin Hospital of Wuhan University,Hubei Province,Wuhan430060,China)

机构地区：[1]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《中国医药导报》2022年第4期57-61,共5页China Medical Herald

基　　金：湖北省重点研发计划项目(2020BCB017)。

摘　　要：为了减少标准通道经皮肾镜取石术(PCNL)带来的并发症,自2001年开始,微通道经皮肾取石术(MPCNL)逐渐被用于肾结石的治疗。MPCNL不仅减小了通道大小,还配备相应的套件,使其在减少并发症发生的同时,仍保留高效的清石率。随着MPCNL技术的不断改良与成熟,其适应证不断扩大。本文对MPCNL在治疗不同类型肾结石中的应用进行了简要综述,相较于其他肾结石治疗方式,MPCNL对于1~2 cm单发肾结石尤其是肾下盏结石的治疗具有一定优势,对于2~3 cm单发肾结石的治疗也有逐渐代替标准PCNL的趋势。在处理复杂或特殊类型肾结石时,单通道MPCNL常具有小通道的局限性,而多通道MPCNL或者多镜联合的方式则可以在保证安全性的前提下提高清石率。因此,以MPCNL为基础的治疗方式有望成为各类型肾结石治疗的重要手段。In order to reduce the complications associated with standard channel percutaneous nephrolithotomy(PCNL),miniaturized percutaneous nephrolithotomy(MPCNL)has been used for the treatment of kidney stones since 2001.MPCNL not only reduces the channel size,but also comes equipped with kits that allow it to reduce complications while maintaining efficient stone removal rates.As MPCNL technology continues to improve and mature,its indications continue to expand.In this paper,the application of MPCNL in the treatment of different types of kidney stones is briefly reviewed.Compared with other treatment methods for kidney stones,MPCNL has certain advantages in the treatment of 1-2 cm single kidney stone,especially lower calyceal kidney stone,and tends to gradually replace standard PCNL in the treatment of 2-3 cm single kidney stone.In the treatment of complex or special types of kidney stones,single-channel MPCNL often has the limitation of small channel,while multi-channel MPCNL or multi-mirror combination can improve the stone clearing rate under the premise of ensuring safety.Therefore,MPCNL-based treatment is expected to become an important means for the treatment of all types of kidney stones.

关 键 词：微通道经皮肾镜取石术 肾结石 通道建立 复杂结石 多镜联合 

分 类 号：R692.4[医药卫生—泌尿科学]