摘要
目的探讨微创经皮肾镜气压弹道碎石术（MPCNL）治疗复杂性肾结石的疗效。方法对我院2006年1月～2008年10月采用微创经皮肾镜气压弹道碎石术治疗42例复杂性肾结石的临床资料进行回顾性分析，其中鹿角型结石13例，多发性肾盂、肾盏结石22例，巨大肾盂结石5例，孤立肾结石2例，在C臂机X线定位穿刺，筋膜扩张器扩张至F16或F18，留置peel away鞘，建立经皮肾取石通道后，采用气压弹道碎石机击碎结石。结果本组42例复杂性肾结石，行一期单通道取石39例，双通道取石2例，另有1例因扩张经皮肾通道时出血较多，留置肾造瘘管一周后行二期取石；一次结石取净率86％（36／42），手术时间40～140min，平均90min。肾造瘘管留置5～12d，平均7d；术后。肾脏反复出血1例，输血并行超选择性肾动脉栓塞治愈，2例并发脓肾者吸除脓液、脓块后碎石，术后出现高热，经用抗菌素治愈，6例术后残石行辅助体外震波碎石。结论微创经皮肾镜气压弹道碎石术治疗复杂性肾结石具有微创、安全、出血少、结石清除率高及术后恢复快等优点，值得临床推广应用。
Aim To evaluate the curative effect of mini - percutaneous nephrolithotomy （MPCNL） for complic renal calculus. Methods 42 cases of complic renal calculus who underwent MPCNL, form January 2006 to October 2007,were retrospectively analyzed. Result 39 subjects underwent primary single tract removing stones ,2 subjects underwent dual pathways removing stones, one patients delayed one week because of significant hemorrhage during dilatation of kidney stoma. The mean operation time of the mini-percutaneous nephrolithotomy was 90 minutes（40 - 140 min） ,the one time clearance 86% （36/42） ,the drained tube mean duration 7 days（5 - 12 d）. One patients needed blood transfusion and uhraselection thrombosis of renal artery because of kidney hemorrhage after operation. 2 cases with surgical kidney were cured after liquor puris resorption. In addition, 6 cases with surplus calculus were cured by ESWL. Conclusion Mini- percutaneous nephrolithotomy is safer and more effective with little trauma, little hemorrhage, rapid recovery and high clearance, which is worth clinically popularizing.
出处
《安徽医药》
CAS
2009年第5期532-533,共2页
Anhui Medical and Pharmaceutical Journal
基金
淮北市科技局科研项目(No080248)
关键词
经皮肾穿刺取石术
肾结石
手术
percutaneous nephrolithotomy
renal calculus
surgery
