微创经皮肾穿刺碎石取石术治疗上尿路结石

Minimally Invasive Percutaneous Nephrolithotomy for Upper Urinary Tract Calculi

目的探讨采用微创经皮肾穿刺碎石取石术(minimally invasive percutaneous nephrolithotomy,mPCNL)治疗上尿路结石的安全性及有效性。方法我院2003年10月~2006年12月使用KarlStorzF8/9.8硬性输尿管镜联合国产气压弹道碎石机,采用mPCNL治疗上尿路结石127例。结果125例一次穿刺成功,2例穿刺失败中转开放手术,结石清除率89.8%(114/127)。手术时间78~185min,平均108min;术后肾造瘘管留置5~11d,平均7d;术后住院5~12d,平均8.1d。输血2例。1例术后8d肾造瘘口大出血,经高选择性肾动脉栓塞止血治愈。117例获随访1~16个月,平均5.3月,B超或X线片检查,未见结石复发。结论mPCNL具有结石清除率高、创伤小、恢复快、住院时间短等优点,是治疗上尿路结石的一种安全、有效的方法。

Objective To evaluate the safety and feasibility of minimally invasive percutaneous nephrolithotomy (mPCNL) for the treatment of upper urinary tract calculi. Methods From October 2003 to December 2006, mPCNL was performed on 127 patients suffering from upper urinary tract calculi by using Karl Storz F8/9.8 rigid ureteroscope and homemade pneumatic ballistic lithotriptor. Results Of the 127 cases, mPCNL was completed in 125, and was converted to open surgery in 2. The rate of stone removal was 89.8% (114/127...