B超引导下肾上盏入路经皮肾镜取石术治疗肾铸型结石

Upper pole access for percutaneous nephrolithotomy under B-ultrasound guidance in treatment of kidney staghorn calculi

目的:探讨B超引导下肾上盏入路经皮肾镜取石术(PCNL)治疗肾铸型结石的安全性及临床疗效。方法:我们于2005年1月～2011年8月对27例肾铸型结石采用B超引导下肾上盏入路PCNL。建立经皮肾通道F24,经皮肾镜下EMS碎石清系统碎石。回顾性分析27例患者的手术时间、结石清除率、并发症等临床资料。结果:本组27例均成功建立经肾上盏通道,其中经第11肋间25例,经第12肋下2例。手术时间50～140min,平均85min。一期结石清除率85.2%(23/27)。胸腔积液1例(3.7%),输血1例(3.7%),无重要脏器损伤及其他严重并发症。结论:B超引导下肾上盏入路PCNL治疗铸型肾结石安全、有效。

Objective：To evaluate the efficacy and safety of upper pole access for percutaneous nephrolithotomy （PCNL） under Bultrasound guidance for kidney staghorn calculi treatment. Method：From January 2005 to August 2011, we treated 27 patients of kidney staghorn calculi by upper pole access for PCNL under B--ultrasound guid- ance. Working tunnels F24 were established through the 11th intercostals or below the 12th ribs . EMS was used to disintegrate and remove stones by nephroscopy. Clinical data including operation time, complications and stone free rate were analyzed retrospectively. Result：All the operations were successfully completed. Among these cases, there were 25 cases through the ]lth intercostals, 2 cases below the i2th ribs . The average operation time was 85 minutes （ range from 50 minutes to 140 minutes） . Stone-free rate is 85.2%（23/27）for single procedure. 1 cases （3.7 % ） had hydrothorax and one patient （3.7 % ）required blood transfusion. The patients had no important organ injury and no other severe complications. Conclusion：Upper pole access for percutaneous nephrolithotomy under B- ultrasound guidance for kidney staghorn calculi is an effective and safe therapy.