经皮肾穿刺微造瘘取石术治疗复杂性肾结石65例

目的探讨B超引导下经皮肾穿刺微造瘘碎石取石术(MPCNL)治疗复杂性肾结石的安全性与有效性。方法对2008年5月～2010年6月65例采用B超引导下MPCNL治疗的复杂性肾结石患者资料进行回顾性分析。结果 65例经皮肾穿刺微造瘘取石术均顺利完成,其中一次取石54例,二次及以上取石11例,单通道取石62例,多通道取石3例。结石清除率为89%,术中估计出血量平均约150ml,平均手术时间110min,术后平均住院时间7d,无术中大出血,术后大出血1例,经B超选择性肾动脉栓塞治疗后痊愈,无中转开放手术病例。结论 B超引导下经皮肾穿刺微造瘘碎石取石术具有安全性高、创伤小、并发症少和恢复快的优势,疗效确切,是治疗复杂性肾结石的良好方法之一。

Objective To evaluate the safety and efficiency of ultrasoun.d-guided minimally invasive percutaneous nephrolithotomy （MPCNL） in treating complex renal calculi. Methods The writers retrospectively investigated 65 cases who underwent ultrasound-guided MPCNL for complex renal calculi from Mayl 2008 to June 2010. Results All the cases were successfully performed by ultrasound-guided MPCNL,with one section procedure in54 oases ,and two sections or m ore in 11 cases. Single tract in 62 cases, multiple tracts in 3 cases respectively. The stone-free rate was 89%.The average operation time was 110 minutes, the estimated blood loss volume was 150 mL and the postoperative average hospitalization time was 7 days. No hematorrhea occurred during operation, and postoperative hematorrhea occurred in 1 case who was cured by super selective renal artery embolization. No conversion to open surgery required in all cases. Conclusion Ultrasound-guided MPCNL has advantages of safety, minimal invasian, less complication, postoperative early resumption and shorter hospital stay, which may provide an effective modality for the treatment of complex renal calculi.