经皮肾镜结合辅助方法治疗复杂肾结石83例分析

Analysis of 83 patients with complicated renal calculi treated with percutaneous nephroscopy

目的探讨应用经皮肾镜碎石取石术(PCNL)一次性手术完全清除结石,提高治疗效果。方法应用PCNL结合一些辅助方法治疗复杂肾结石83例,辅助方法包括:(1)选择结石最靠外的目标肾盏作为穿刺通道;(2)助手外部推移、挤压;(3)穿刺针推移结石;(4)软镜的应用;(5)第二、三通道的选择;(6)原通道二次手术的应用等。结果结石的完全清除率达到了94%,发热、出血等并发症都有了明显减少。结论几种辅助方法可以有效的提高PCNL的治疗效果,减少并发症的发生。

Objective To study the complete clearance rate of renal calculi and to improve the efficacy of percutaneous nephroscopy （PCNL） to complicated renal calculi. Methods A total of 83 patients with complicated renal calculi were treated with PCNL plus assistant methods including （ 1 ） choosing the best puncture point; （ 2 ） moving the relative area by assistant; （ 3 ） moving the stone by puncture needle ; （4） using flexible cytoscopy ; （ 5 ） creating new tunnel ; （ 6 ） reoperating via the original tunnel, et al. Results The completely removal rate was 94% and the complications were significantly decreased. Conclusion To use the assistant methods to PCNL can improve the therapeutic efficacy in patients with complicated renal calculi.