摘要
目的:探讨微创经皮肾取石术(mPCNL)治疗上尿路结石建立取石通道的重要性及临床疗效。方法:2007年3月～2008年11月应用mPCNL治疗上尿路结石患者500例570侧。所有患者均行F_(16)通道穿刺取石,其中单通道取石425例,多通道取石75例。结果:570侧肾脏采用单通道一期和分期mPCNL共635次;双通道一期和分期mPCNL共97次;三通道一期和分期mPCNL共6次。单通道术后8例有残石,1例大出血,1例迟发性脾破裂出血;双通道术后5例有残石,1例大出血,2例血气胸,1例肝破裂大出血;三通道术后1例有残石。所有并发症经过积极地相应治疗后均痊愈。结论:单通道mPCNL可以治疗绝大部分上尿路结石;多通道mPCNL在复杂结石治疗中更具优势,但并发症相对较多;保留通道分期手术可明显提高结石清除率。
Objective：To investigate the importance and the clinical efficacy of the establishment of the channel in the treatment of minimally invasive percutaneous nephrolithotomy （mPCNL）for upper urinary tract calculi. Methods： From March 2007 to November 2008, 500 cases （570 kidneys） of mPCNLfor the treatment of upper uri nary tract calculi were reviewed. All patients were treated in F^6 puncture channel percutaneous nephrolithotomy, of which 425 cases treated in single-channel, 75 cases in multi channel. Results：There were 570 kidneys using one and multi stages mPCNL in single channel, total of 635 times; one and multi stages mPCNL in dual-channel, total of 97 times; one and multi stages mPCNL in three-channel total of 6 times. After single channel mPCNL, there were 8 cases with residual calculi, 1 case of bleeding, 1 case of delayed bleeding spleen; after dual-channel, there were 5 cases with residual calculi,1 case of bleeding, 2 case of hemopneumothorax,1 case of liver bleeding. After three-channel mPCNL, only 1 case had residual stone. All the complications were cured when treated with prompt and corresponding measures. Conclusions： Single-channel mPCNL can treat most of the upper urinary tract calculi; multi-channel mPCNL acted better in the treatment of complex urinary tract calculi, but combinded with more complication relatively; retain channel for phased operation improved stone-free rate significantly.
出处
《临床泌尿外科杂志》
北大核心
2009年第3期173-175,共3页
Journal of Clinical Urology
关键词
上尿路结石
微创经皮肾取石术
通道
upper urinary tract calculi
minimally invasive percutaneous
channel
