微创经皮肾镜取石术治疗多囊肾合并肾结石

Minimally Invasive Percutaneous Nephrolithotomy for Calculi in Patients with Polycystic Kidney

目的 评价微创经皮肾镜取石术（minimally invasive percutaneous nephrolithotomy,MPCNL）治疗多囊肾合并肾结石的疗效和安全性。方法 分析我院2007~2013年16例多囊肾合并肾结石患者接受MPCNL的临床资料。结果 16例均成功建立皮肾通道,平均手术时间40min,平均出血30mL,结石清除率93.75%。手术前后血红蛋白、血肌酐比较,差异无统计学意义（P〉0.05）,1月后血肌酐值下降至（142.69±76.28）μmol/L（P〉0.05）,无输血或血管栓塞病例。随访3~12个月,血红蛋白和血肌酐值稳定,结石无复发,肾囊肿无增大。结论 MPCNL是安全、有效治疗多囊肾合并肾结石的方法之一。

Objective To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy（MPCML）for calculi in patients with polycystic kidney.Methods The clinical datum of 16 patients with renal stones complicated with polycystic kidney who accepted the MPCML were assessed from 2007 to 2013in our hospital.Results The percutaneous nephrostomy channel was successfully established under B-type ultrasound guidance in all patients at the first time.Operation time ranged from 30 to 90minutes,that is,the average time was40 minutes,and blood loss ranged from 5to 60 mL（mean 30 mL）.The clearance of the stone at one session was93.75%（15/16）.The hemoglobin decreased by 10.2g/L.There were no significant differences in the hemoglobin before and after operation[（136.75±6.34）g/L,（121.24±6.67）g/L,P〉0.05].There were no significant changes in the serum creatinine levels before and after MPCNL[（168.34±102.57）μmol/L,（165.76±92.24）μmol/L,P〉0.05].The mean serum creatinine level was slightly decreased（142.69±76.28）μmol/L at 1-month follow-up without blood transfusion or Selective renal artery embolization.There were no difference between hemoglobin and renal function.What＇s more,there still were no stone recurrence and no enlargement in the cyst in the 3-12 months following up.Conclusion MPCNL is safe and reliable way for the treatment of stones in the patients with polycystic kidney.