单通道一期经皮肾镜取石术联合体外冲击波碎石治疗无积水鹿角形肾结石

Treatment of un-hydronephrotic staghorn renal calculi under singl-channel one-stage percutaneous nephrostolithotomy combined with ESWL

目的探讨单通道一期微创经皮肾镜取石术(MPCNL)联合体外冲击波碎石(ESWL)治疗无积水鹿角形肾结石的临床效果。方法回顾分析43例单通道一期微创经皮肾镜取石术联合ESWL治疗无积水鹿角形肾结石患者的临床资料。结石大小2.5cm×2.9cm～3.2cm×5.6cm,平均3.3cm×4.4cm。结果43例均成功施行了单通道一期经皮肾镜气压弹道碎石取石术,平均手术时间141min,结石清除率60.5%(26/43),无严重并发症。术后2个月内17例残石联合ESWL(1～3次)治疗,结石总清除率93.0%(40/43)。术后随访3～6个月,未发现MPCNL及ESWL的严重并发症。结论单通道一期经皮肾镜取石术联合ESWL治疗无积水鹿角形肾结石具有结石清除率高、创伤小、并发症少等优点,可作为鹿角形肾结石的治疗方法。

[ Objective ] To evaluate the efficacy of singl-channel one-stage mini-percutaneous nephrostolithotomy （M-PCNL） combined with ESWL in patients with un-hydronephrotic renal staghorn calculi. [Methods ] 43 cases of un-hydronephrotic staghorn renal calculi including 27 males and 16 females were selected to be treated by singlchannel one-stage percutaneous nephrostolithotomy combined with ESWL. The age of the patients was 22 to 65,43 years old on average;the size of calculi was 2.5 cm×2.9 cm-3.2 cm×5.6 cm, 3.3 cm×4.4 cm on average. [Results] Singl-channel one-stage MPCNL was successfully performed in all the cases. The average operation time was 141 minutes, the stone-free rate was 60.5%（26/43）, there were no several complication in all the cases. 14 cases with residual calculi had ESWL were rendered stone free in two moths later and the clearance rate reached 93.0% （40/ 43）. All the 43 patients were followed up for 3 to 6 months, none of them had several complication of M-PCNL and ESWL. [ Conclusion ] Singl-channel one-stage M-PCNL combined with ESWL has good therapeutic effect in treating un-hydronephrotie staghorn renal calculi since the technique makes the rate of stone-free highter, the operation wounds smaller and the rate of complication lower.