微创经皮肾穿刺输尿管镜碎石治疗复杂上尿路结石52例

Treatment of complicated upper urinary tract calculi by minimally invasive percutaneous nephrolithotomy ureteroscopy lithotripsy: report of 52 cases

目的探讨微创经皮肾穿刺输尿管镜碎石术（Min-PCNL）治疗复杂上尿路结石的疗效及安全性。方法回顾性分析微创经皮肾穿刺输尿管镜碎石术治疗复杂上尿路结石52例临床资料。结果 52例经手术均成功取石,Ⅰ期取石率92.3%（48/52）,Ⅱ期取石4例。双通道取石8例。手术时间平均（84.2±3.5）min,平均出血（88.5±6.0）ml,肾造瘘管留置3~8 d（4.5±0.5）d,术后6~8 h进食,平均住院（5.5±0.5）d,全部患者未出现延迟性出血等严重并发症。结论该手术具有微创、恢复快、手术时间短、结石取净率高、安全可靠等优点,可作为复杂肾结石的首选治疗方法。

Objective To analyze and discuss the the efficacy of minimally invasive percutaneous nephrolithotomy URSL（ Min-PCNL） on complex urinary tract stones and its safety. Methods A retrospective analysis of minimally invasive percutaneous nephrolithotomy URSL for complicated urinary tract stones was done on 52 patients. Results All the 52 patients were successful in removal of stones,with phase-1 removal rate of 92. 3%（ 48 /52）. Phase-2 removal of stones was performed in four patients,and removal of stones was completed via dual accesses in eight patients. Mean operation time was（ 84. 2 ± 3. 5） min,average blood loss was（ 88. 5 ± 6. 0） ml,nephrostomy catheter indwelling time was 3- 8（ 4. 5 ± 0. 5） d,first time postoperative eating was at 6- 8 h after operation,and average length of stay in hospital was（ 5. 5 ± 0. 5） d. Delayed bleeding and other serious complications did not occur in all the cases. Conclusion Minimally invasive percutaneous nephrolithotomy is minimally invasive,safe and reliable. It can be used as the preferred method to treatment of complex urinary tract stones.