经皮肾镜钬激光治疗复杂肾结石35例临床体会

Clinical experience of 35 cases complex renal calculi with holmium laser by percutaneous nephrolithotomy

目的探讨微创经皮肾镜钬激光碎石术(mPCNL)治疗复杂性肾结石的方法与效果。方法回顾性分析2008年8月～2010年8月笔者所在医院mPCNL治疗35例复杂性肾结石患者的临床资料,术后随访并评价1个月结石清除率。结果 35例患者手术均成功,无1例中转开腹手术。无肾切除、肾功能受损、感染性休克等严重并发症;1个月结石清除率为80%(28/35)。结论微创经皮肾镜钬激光碎石具有结石清除率高、创伤小、恢复快、并发症低等优点,是复杂性肾结石的首选治疗方法。

Objective To evaluate methods and effects of the minimally invasive percutaneous nephrolithotomy holmium laser lithotripsy （mPCNL） in the treatment of complex kidney stones. Methods To analyze the clinical data of 35 cases with complex renal calculi who had underwent mPCNL. Patients were followed up and 1 month stone - free rate was evaluated. Results 35 patients were operated successfully,with no conversion to open surgery. There was no nephrectomy, renal impairment, serious complications such as septic shock ; 1 month stone clearance rate was 80% （28/35）. Conclusion Minimally invasive percutaneous nephrolithotomy with holmium laser is the preferred method for treatment of kidney stones, with high stone clearance rate, little trauma, rapid recovery, and low complications.