局麻下微创经皮肾穿刺钬激光碎石治疗肾结石

Study of minimally invasive percutaneous nephro-lithotomy on renal calculi under local anesthesia

目的：探讨局麻下微创经皮肾穿刺（MPCNL）钬激光砟百治疗肾结石的效果。方法：对34例（46侧）肾结石采用局麻下超声引导MPCNL，建立通道后通过输尿管镜/肾镜探查结石，钬激光粉碎及取石。结果：全部病例单次治疗均经过单通道完成，其中1次治疗14侧，2次治疗26侧，3次治疗6侧，穿刺2个通道者9侧。结石总排尽率80．4％（37／46侧），手术时间为1．7～4．5h，平均3．3h，均无明显并发症。结论：局麻下建立MPCNL、钬激光治疗肾结石，是一种安全有效的微创治疗方法。

Objective：To study the clinical experiences of the minimally invasive percutaneous nephrolithotomy （MPCNL） treatment on renal calculi under local anesthesia. Methods：There were 34 patients suffered with 46 lateral renal calculi treated by MPCNL. The channel was created under local anesthesia and ultrasound guidance. The calculus was crushed into pieces via the channel by Holmium： YAG laser. Results：All of the cases were received the MPCNL via single channel under local anesthesia. The processes performed were 1 times in 14 lateral, 2 times in 26 lateral, and 3 times in 6 lateral renal. The percutaneous nephro-puncture was performed 2 times in 9 lateral renal. The total stone clearance amounted to 80.43% （37/46 lateral）. The operation duration was 1.7-4.5h, averaged to 3.3h. No serious complications were observed. Conclusions： These results suggested that the MPCNL with Holmium：YAG laser was an ideal and effective treatment on renal calculi. It can be well done under local anesthesla.