微创经皮肾取石术中狭窄盏口肾盏内结石处理策略探讨

Treatment for calculus in stenosis kidney calices during minimally invasive percutaneous nephrolithotomy

目的对微创经皮肾取石术(MPCNL)中狭窄盏口肾盏内结石的处理策略进行探讨。方法回顾分析2009年11月至2011年10月的99侧例病例,对比不同方法处理狭窄盏口致并发症的发生率。结果采用改良方法处理狭窄盏口,MPCNL肾盏颈口撕裂、术野不清、术中或术后输血、盏内结石残留、被迫中止手术等发生率均有显著减少。结论在MPCNL术前、术中采取适当的措施减少或避免肾盏撕裂的出现,不仅可以减轻患者痛苦、减少输血,而且可以提高清石成功率,应当引起MPCNL术者的重视。

Objective To explore the treatment method for calculus in stenosis kidney calices during MPCNL. Methods All 99 cases from November 2009 to October 2011 were reviewed, and the rate of complication with different methods of treatment was compared for calculus in stenosis kidney caliees during MPCNL. Results Modified method significantly reduced the rate of kidney ealices tear, unclear sur- gical field, blood transfusion during or after operation, stone remains and compulsive surgery stop. Conclusion Proper measures should been taken before and during operation of MPCNL, which would not only decreases the pain of patients and the blood transfusion amount, but also in- creases the rate of stone clearance and surgical success.