经皮肾镜碎石术治疗肾结石的研究进展

Research Progress of Treating Renal Calculi with Percutaneous Nephrolithotomy

近年来,经皮肾镜取石术(PCNL)已被广泛地应用于肾结石治疗,其手术体位有俯卧位、侧卧位、仰卧位、斜卧位、腰肋悬空位。定位穿刺技术主要有C臂X线引导定位穿刺、B型超声引导定位穿刺、CT定位穿刺;碎石技术以气压弹道碎石、超声碎石、钬激光碎石、联合碎石为主。PCNL的并发症注意出血、感染、胸膜损伤、结石残留、肾脏、输尿管及邻近脏器损伤的防治。PCNL是否会对肾实质及其功能产生影响,目前还存在争议。

In recent years,PCNL has been widely used in treatment of renal calculi. Its operation posture includes prone position,lateral position,supine,recumbent,flank suspended; puncture technology mainly includes C arm X-ray guided puncture,B ultrasound guided puncture,CT positioning puncture; crushing technique includes pneumatic lithotripsy,ultrasonic lithotripsy,holmium laser lithotripsy,and combined crushing technology. Complication such as bleeding,infection,injury of pleura,residual stones,kidney,ureter and adjacent organ injury should be prevented and treated. Whether PCNL has an impact on renal parenchyma and function is still controversial.