C型臂X线定位MPCN治疗复杂性肾结石48例

Treatment of nephrolith with micro-percutaneus nephrolitbotomy guided by C-arm X-ray:a report of 48 cases

目的：探讨C型臂X线定位微创经皮肾穿刺造瘘取石术（MPCNL）在治疗复杂性肾结石的临床应用。方法：对48例复杂性肾结石患者,在C型臂X线机定位下选择最佳目标肾盏作为第1个经皮肾穿刺通道,对于该工作通道取不到的结石再用C型臂重新定位穿刺,建立第2个或以上经皮肾通道。结果：对48例患者施行共53例次MPCNL,其中43例I期完成,5例II期完成;单通道取石36例次,双通道及双通道以上取石17例次;结石清除率9 5%;术中平均出血量100 m l,术中均不需输血;术后无严重并发症发生,肾造瘘管术后3~5 d内拔除,术后住院时间7~10 d,平均8 d;双J管术后1~3个月内拔除。结论：C型臂X线定位微创经皮肾穿刺造瘘取石术是治疗复杂性肾结石的一种有效方法,具有创伤小、恢复快、并发症少的优势。

Objective To discuss the feasibility of nephrolith treatment with percutaneous nephrolithotomy guided by C-arm X-ray.Method On 48 cases of patients with nephrolith,c-arm x-ray positioning down to choose the best target calyx as first percutaneous nephrolithotomy channel,the channel access stones with c-arm positioning,puncture,the establishment of 2 or more kidney channels.Results On a total of 48 cases of carrying out of the 53 cases,of which 43 cases MPCNL I period is complete,phase II completed in 5 cases;single channel for 36 cases,dual-channel and dual channel above for 17 cases;stone clearance was 95%;the average amount of bleeding during surgery are 100 ml without blood transfusion;no serious complications,nephrostomy tube within 3~ 5 days after surgical removal,postoperative hospital stay 7~10 days,an average of 8 days;double J tube after 1~3 months.Conclusion It is safe and effective to treat nephrolity with percutaneous nepohrolithotomy guided by C-arm X-ray.