微创经皮肾镜气压弹道碎石的临床应用

Minimally invasive percutaneous nephrolitithotomy in treatment of upper urinary lithiasis

目的探讨与评价微创经皮肾镜气压弹道碎石(MPCNL)治疗肾与输尿管上段结石的方法与疗效。方法回顾性分析2006年10月～2009年10月采用MPCNL治疗的198例肾结石患者的临床资料。结果 198例患者均成功建立皮肤肾脏通道,其中1次取净结石149例,2次取净45例,3次取净4例。结石总取净率为75.7%,手术时间平均为55 min,术中出血量50～150 ml,平均70 ml,1次取净结石患者住院时间平均7 d,随访1～12个月,无严重手术并发症发生。结论微创经皮肾镜气压弹道碎石术治疗上尿路结石具有微创损伤、恢复快、并发症少、安全高效、结石清除率高的优点。

Objective To investigate and access the clinlal technique and efficacy of minimally invasive percutaneous nephrolithotomy combined contact pneumatic lithoripsy for upperurinary lithiasis treatment. Methods From October 2006 to October 2009,the clinicd date of 198 cases of kidney stones under PCNL. Results All thepercutaneous renal tunnel was suc- cessfully established. 149cases presented stone free on the first MPCNL,45 cases presented stone free on the second MPCNL, 4 cases presented stone free on the third MPCNL. The mean operation time of the miniper cutaneous nephrolithotomy was 55minutes, the one time elearcace 75.7 %. The intraoperative blood loss was 50 - 150 ml, mean 70 ml,the length of postoperative hospital stay was seven days, no serious surgery concerned complication occurred during nephrolithotomy after 1 to 12 month fellow up. Conclusion The minimally invasive percutaneous nephrolithotomy combined pneumatic device appears to be minimally invasive, quick recovery,less complication, efficacious, safe and high stone -free rate for upper urinary calculi