局麻下微通道经皮肾镜取石术

Minimally invasive percutaneous nephrolithotomy under local anaesthesia

目的探讨局麻下微通道经皮肾镜取石术(MPCNL)治疗肾结石的可行性及效果。方法分析我院近6年来在利多卡因局麻下行MPCNL186例患者的临床资料,其中肾盂结石6例,MPCNL术后结石残留180例,结石大小0.5～2.0cm。结果186例患者实施局麻下MPCNL,184例顺利完成,2例因疼痛难以耐受而放弃局麻手术,局麻总有效率98.9%;结石取净166例,残留结石18例,结石取净率89.5%,手术时间10～65min,平均(25±8)min。结论对于简单肾结石或MPCNL术后肾结石残留,局麻下MPCNL技术可行、安全有效。

Objective To investigate the feasibility and the clinical efficacy of minimally invasive percutaneous nephrolithotomy （MPCNL） under local anesthesia for the treatment of renal calculi. Methods We analyzed the therapeutic efficacy of 186 patients with renal stones who were performed MPCNL under local anesthesia （lidocaine） in recent six years. In our study, 6 patients were treated on first stage MPCNL for simple renal calculi and 180 patients on second stage MPCNL for residual stones. Results All patients were accept the operation and 184 patients were Successful. 2 patients gave up treatment because of pain. The effective rate of local anesthesia was 98.9%. The stones were removed completely in 166 patients and 18 cases were residual stones. The rate of stone free was 89.5%. The mean operative time was 25±8 min. Conclusion Our study indicates that MPCNL under local anesthesia is safe and effective for simple renal stones and residual stones after MPCNL. Patients with this procedure were well tolerated.