微创经皮肾穿刺取石术治疗肾结石的临床体会

Clinical Experience of Treating Renal Calculi with Minimally Invasive Percutaneous Nephrolithotomy and Nephrolithotripsy

【目的】探讨微创经皮肾穿刺取石术(MPCNL)治疗肾结石的疗效。【方法】对接受MPCNL治疗的450例肾结石患者进行了回顾性分析。其中单发肾盂、肾盏结石285例,肾铸型或鹿角形结石115例,双侧肾结石26例,手术后残留结石24例。【结果】450例均行一期穿刺取石,其中1次取石326例,2次以上取石124例;单通道取石408例,多通道取石42例,结石取净率88.5%。手术时间平均110 min;术中、术后有明显出血5例(3%),均经保守治疗治愈,平均住院时间9 d。【结论】MPCNL具有创伤小,出血少,结石取净率高,患者康复快,疼痛轻的优点,是一种有效的治疗肾结石的方法。

[Objective]To evaluate the efficiency of minimally invasive percutaneous nephrolithotomy in treating renal calculi. [Methods]Four hundred fifty patients with renal calculi were treated with minimally invasive percutaneous nephrolithotomy（MPCNL）. Of 450 cases, pelviocalyceal calculi were in 285 cases, stag horn calculi in115, bilateral renal calculi in 26, postoperative residual stones in 24, respectively. [Results]All cases were performed one-stage procedure, one session procedure in 326, 2 sessions or more in 126. Single tract was made in 408, multiple tracts were made in 42, respectively. The stone-free rate was 88.5 %. Average operative time was 110 minutes. Only 5 cases suffered from massive hemorrhage intraoperatively or postoperatively. They were managed by conservative treatment and cured. The mean hospitalization time was 9 days. [Conclusion]The minimally invasive pereutaneous nephrolithotomy has the advantages of less trauma, bleeding and pain,with rapid recovery, so it is an effective method for the treatment of renal calculi, and open surgery is almost avoidable.