经皮肾微造瘘钬激光碎石取石术治疗复杂性肾结石

Minimally invasive percutaneous nephrolithotomy with holmium laser for the treatment of complicated renal stone

目的总结经皮肾微造瘘钬激光碎石取石术(MPCNL)治疗复杂性肾结石的经验。方法本组复杂性肾结石患者110例,男60例,女50例;其中单侧复杂性肾结石85例,双侧25例。先采用经皮肾微造瘘钬激光碎石取石术治疗,较大残留结石再次行二期MPCNL。结果110例复杂性肾结石(25例为双侧肾结石)患者行123侧MPCNL术,一次取尽结石90例,12例行二期PCNL取尽结石,21例术后残余结石,配合体外冲击波碎石术(ESWL)治疗,总结石取净率82.9%(102/123),平均手术时间为100±20min,出血50±30ml,无大出血、尿瘘、动静脉瘘、腹腔脏器损伤等严重的并发症。结论MPCNL联合钬激光碎石取石术治疗复杂肾结石安全、有效。具有损伤小、恢复快、出血少等优点。

Objective To summarize the experiences of the treatment for complicated renal stone by the minimally invasive percutaneous nephrolithotomy （MPCNL） and extracorporeal shock wave lithotripsy （ESWL）. Methods One hundred and ten patients （60 males and 50 females）with complicated renal stone underwent MPCNL combined with ESWL. There were 85 cases with complicated renal stone in one side and 9 cases in both sides. Results The mean operative time was 100-20 min. Blood loss was 50-30 ml. No severe introoperative complication occured. The stone-free rate of MPCNL was 82.9%. Conclusion MPCNL with ESWL is an effective approach, with mini-invasion, less blood loss, and a short convalescense period.