摘要
目的探讨微创经皮肾镜取石术(MPCNL)治疗开放手术后残留或复发肾结石的有效性与安全性。方法有肾结石开放手术病史的肾结石患者18例,其中曾行肾实质切开取石术8例,肾盂切开取石患者10例,左侧11例,右侧7例。结石单发9例,多发6例,鹿角形3例,结石体积5.0～30.0 cm3。采用C臂X光机引导穿刺,建立16F工作通道,弹道碎石系统碎石。分析手术效果、并发症等。结果18例均成功建立通道并一期手术,其中单通道完成手术13例,双通道5例。经中组肾盏建立通道16例,行下组肾盏建立通道7例。平均手术时间90 min,一期手术清除结石15例,占83.3%。未发生围手术期严重并发症。结论MPCNL可作为治疗开放手术后残留或复发肾结石的安全有效方法。
Objective To explore the efficiency and safty of minimally invasive percutaneous nephrolithotomy in treatment of renal calculi patients with open surgery history of kidney.Methods 18 cases with renal calculi who had open surgery history of kidney were treated by Minimally invasive percutaneous nephrolithotomy.Eight patients had open nephrolithotomy,ten had pyelolithotomy.Eleven calculi were in the left kidney and seven in right side.Nine cases had single stone and six cases had multiple,and three cases had staghorn stones.The stones volum was during 5.0 to 30.0 cm3.All the mini-percutaneous renal access of 16F were established under C-arm X-ray guidance and lithtripsy were performed with pneumatic ballastic system.Operation effect and complications were analyzed.Results All cases were treated successfully in one-session procedure,13 mPCNL were accomplished by single and 5 by double acdesses.Sixteen cases were punctured and established tract through the middle group renal calices and seven through the lower group.The mean operating time was 90 minitues.15 cases were healed well one time（83.3%）.No severe complication occurred.Conclusions Minimally invasive percutaneous nephrolithotomy in treatment of renal calculi patients with open surgery history of kidney is safe and effective.
出处
《实用临床医学（江西）》
CAS
2010年第4期33-35,共3页
Practical Clinical Medicine
关键词
微创经皮肾镜取石术
开放手术后
肾结石
minimally invasive pereutaneous,nephrostomy
open surgery
kidney stone
