微创经皮肾输尿管镜治疗复杂性上尿路结石

Invasive percutaneous nephroscopy ureter

目的探讨微创经皮肾输尿管镜下气压弹道碎石术治疗复杂性上尿路结石的有效性和安全性。方法经皮肾穿刺微造瘘输尿管镜治疗复杂性肾和输尿管上段结石56例患者,其中肾盂肾盏多发性结石26例(平均直径2.8 cm),鹿角状结石18例(平均直径为5.2 cm),输尿管上段大结石12例(平均直径1.6 cm,其中3例为孤立肾)。分析术中碎石时间、结石排净率、并发症发生率等。结果平均碎石取石时间为158 min(60～480 min)一次性治疗结石取净率为64.29%(36/56),总的取净率为80.36%(45/56),术中出血量平均为60 mL,术后有3例患者出现高热,无其他严重并发症。结论微创经皮肾输尿管镜下气压弹道碎石术治疗复杂性肾和输尿管上段结石创伤小,出血量小、效率高,手术并发症低,术后恢复快。

【Objective】To evaluate the safety and efficiency of ballistic lithotripsy＇s minimally invasive pertion-cutaneous nephrolithotomy in complex upper calculi.【Methods】56 patients underwent minimally invasive percuta-neous nephrolithotomy（MPCNL） for complex renal and upper calculi,including multiple calculi of the pelvis and re-nal calyx in 12（the average diameter was 2.8 cm）,staghorn stone of kidney in 18（the average diameter was 5.2 cm）,upper calculi in 12（the average diameter was 1.6 cm,solitary kidney in 3）.The analysis of operation time,the stone-free rate and the rate of complication.【Result】The average stone-free time was 158 minutes（60～480 min-utes）.One section procedure rate was 64.28%（36/56）.The whole stone-free rate was 80.36%（45/56）.The estimated blood loss volume was 60 mL and three patients had a high fever,but no other severe complication was observed.【Conclusion】The treatment of complex upper calculi with minimally invasive percutaneous nephroscopy ureter has the advantages of little trauma,safe,satisfied and less complication.