双微通道经皮肾镜碎石术处理复杂性肾结石的效果观察

Effect observation of double microchannel percutaneous nephrolithotomy in treatment of complex renal calculi

目的探讨双微通道经皮肾镜碎石术处理复杂性肾结石的临床效果。方法 164例复杂性肾结石通过双微通道(16F或18F及20F)经皮肾镜下碎石治疗,观察其临床效果。结果 103例通过一期手术治疗,结石清除率为88.3%,61例通过二期手术处理,结石清除率为91.8%。164例患者,平均出血约50 ml,其中2例出血约300 ml,术后有输血,无严重冲洗液外渗、肾周积脓,均无大出血,胸膜、结肠损伤等严重并发症。结论双微通道经皮肾镜碎石术处理复杂性肾结石,特别是无积水铸型结石,能更好的减少并发症,有效清除结石。

Objective To investigate the clinical effect of double microchannel percutaneous nephrolithotomy in treatment of complex renal calculi. Methods There were 164 patients with complex renal calculi receiving treatment by double microchannel （16F or 18F and 20F） percutaneous nephrolithotomy, and their clinical effects were observed. Results There were 103 cases receiving stage one operation, with calculi clearance rate as 88.3%, and 61 cases receiving stage two operation, with calculi clearance rate as 91.8%. The average bleeding volume of 164 cases was 50 ml, and 2 cases of them had approximately 300 ml of bleeding. They received postoperative blood transfusion, without severe complications as severe flushing fluid extravasation, perinephric empyema, massive haemorrhage, pleura, and colon injury. Conclusion Double microchannel percutaneous nephrolithotomy in treating of complex renal calculi, especially stag horn calculi without dropsy, can reduce complications and effectively eliminate calculi.