微创经皮肾输尿管镜取石术治疗感染性肾结石的体会

Therapy of minimally invasive percutaneous nephrostomy lithotripsy for infection-induced renal calculi.

目的 总结微创经皮肾输尿管镜气压弹道碎石术治疗感染性肾结石的临床经验。方法 回顾性分析2003年9月至2005年12月采用微创经皮肾输尿管镜气压弹道碎石术治疗感染性肾结石的48例患者资料，分析其病史、临床检查特点、手术方法、注意事项和并发症及结石取净率等临床特点。结果 结石的总取净率为77．08％（37／48），术后配合ESWL，结石总排净率为93．75％（45／48）。并发症为高热5例（10．42％）、术中大出血4例（8．33％）、术后继发性出血2例（4．17％），肾盂穿孔1例（2．08％），平均术后住院天数8．6d。结论 只要做好充分的围手术期处理，提高手术技巧，重视并发症的预防，微创经皮肾穿刺造瘘气压弹道碎石术治疗感染性肾结石是一种并发症少、创伤小、恢复快、结石排净率高的有效方法。

Objective To summarize the clinical experience of minimally invasive percutaneous nephrostomy pneumatic lithotripsy （MPCNL） for the treatment of infection-induced renal calculi. Methods The data of 48 patients （26 men and 22 women, the mean age was 39 years） with infection-induced renal calculi who underwent MPCNL from September 2003 to December 2005 were analyzed retrospectively. Results The total stone-free rate was 77. 08% （37/48）, and 93.75% （45/48） after operation with ESWL. Complications ： high fever in 5 cases （ 10.42% ）, intraoperative massive hemorrhage in 4 cases （8.33%）, postoperative secondary bleeding in 2 cases （4.17%）, perforation of the renal pelvis in 1 case （2.08%）. The mean postoperative hospital stay was 8.6d. Conclusion MPCNL is a minimally invasive and effective treatment with less complications, rapid recovery and high stone-free rate for infection-induced renal calculi.