微创经皮肾穿刺取石术治疗泌尿系结石19例临床分析

The preliminary treatment experience of upper urinary tract calculi with mini-percutaneous nephrolithotomy:report of 19 patients

目的:探讨微创经皮肾穿刺取石术治疗上尿路结百的方法。方法:对19例尿路结石患者采用在B超或X线引导下微创经皮肾穿刺取石术一期治疗,其中15例患者采用B超引导下定位手术,4例采用在X线引导下定位手术。结果:所有患者均成功建立经皮肾通道。一期结石清除率47.4%,平均手术时间30-240 min,无严重并发症发生。结论:微创经皮肾穿刺取石术是一种安全、高效的上尿路结石治疗方法,对肾功影响很小,对复杂结石尤其适用,微刨穿刺建立皮肾工作通道是碎石成功的关键技术。

Objective： To study and summarize the mini-percutaneous nephrolithotomy in treatment of upper urinary tract calculi. Methods： 19 patients were treated by this minimally invasive therapy under B ultrasonic or X rays guidance from July 2005 to August 2005. Results： 15 patients were guided by B ultrasonography and 4 patients were guided by X rays, the scar volume were 20 F or 16 F respectively. All cases were successfully constructed a percutaneous work-way. The stone-free rates were 47.4% at the first procedure. The average operative time were 30-240 munites. No severe complications were noted in all patients. Conclusions： Minimally percutaneous nephrolithotomy is a safe and effective technique in treatment of upper urinary tract calculi. It can be performed at one, two or three sessions and is mini-harm to renal function. It is a good method for the complicated stone cases. The key technique is how to construct a percutaneous work-way.