超声引导下微创经皮肾取石术治疗肾结石

Treatment of renal calculi with minimally invasive percutaneous nephrolithotomy under the guide of B ultrasound

目的探讨超声引导下微创经皮肾取石术(MPCNL)治疗肾结石的可行性和安全性。方法回顾性分析45例采用超声引导下MPCNL治疗肾结石的资料。结果本组患者均行一期穿刺取石,共行45次手术,手术时间90～225min,平均140min;肾造瘘管留置时间4～6d,平均5d。平均住院时间7d,其中单发肾结石患者住院时间6～8d。无输血,1例术后3d并发高热,经引流、抗炎治疗1周后治愈。一期取石后的残留结石行体外冲击波碎石。2例术后辅用体外冲击波碎石(ESWL)治疗。结石清除率95.6%。无术中、术后严重出血,无周围脏器损伤。结论超声引导下MPCNL治疗肾结石具有创伤小、恢复快及并发症少等优点,治疗肾结石安全有效,适合在基层医院开展。

Objective To evaluate the feasibility and safety of minimally invasive percutaneous nephrolithotomy（MPCNL）under the guide of B ultrasound in treating renal calculi.Methods The data of 45 patients with renal calculi who had undergone PCNL were retrospectively analyzed.Results All the 45 cases underwent one-stage PCNL（45 operations altogether）.The mean operative time was 140 min（ranged from 90～225 min）;Average retention time of nephrostomy tube was 5 days（ranged from 4-6 days）.The average hospital stay was 7 days（6～8 days in the patient with single renal calculi）.No blood transfusion was needed during operation.1 case had got a high fever 3 days after operation and was cured by drainage and anti-infection for one week.The residual stones after one-stage PCNL were treated by ESWL.2 cases were treatd ESWL after operation.The total stone clearance rate was 95.6%.No severe hemorrhage and peripheral organs injured were observed.Conclusion Treatment of renal calculi with MPCNL under the guide of B ultrasound has advantages of minimal trauma,quickly recover and fewer complications.It is safe and effective in treating renal calculi in primary hospital.