微创经皮肾造瘘输尿管镜取石术治疗上尿路结石

Treatment of upper urinary calculi with Mini-percutaneous nepholithotomy

目的:探讨微创经皮肾造瘘输尿管镜取石术治疗上尿路结石的临床疗效。方法:通过微创经皮肾造瘘通道,对176例肾结石,42例输尿管上段结石实施气压弹道碎石取石术。结果:218例患者中,单通道治疗197例(90.3%),双通道治疗21例(9.7%),一期取石189例(86.7%),二期取石29例(13.3%)。结石取尽率为92.6%(202/218)。除1例结肠损伤改行开放手术,1例术后严重出血经超选择肾动脉栓塞治愈外,无严重并发症发生。结论:微创经皮肾造瘘输尿管镜取石术创伤小,结石清除率高,并发症少,是治疗上尿路结石的安全有效的方法。

Objective：To investigate the clinical outcoms of minimally invasive percutaneous nephrolithotomy（mpcnl）in upper urinary calculi treatment.Methods：Totally 176 cases of renal calculi patients and 42 cases of patients with upper ureteral calculi were treated by minimally invasive percutaneous nephrolithotomy.Results：Single channel was used in 197 cases（90.3%）,two channel in 21 cases（9.7%）,there were 189 cases（86.7%）treated with one-stage operation,29 cases（13.3%）with two-stage.The overall successful stone fragmentation rate withstone-free expectoration of the ureteral and renal calculi was 92.6%（202/218）,one patient converted to open surgery because of colon injury,the other with severe bleeding were treated with blood transfusion and superselective renal atrery embolization.Conclusions：The technique of mpcnl was safe and effctive for the treatment of upper urinary calculi.