经皮肾镜钬激光碎石治疗海绵肾肾结石(附30例报告)

Percutaneous nephroscope holmium laser lithotripsy in the treatment of medullary sponge kidney stone(Report of 30 cases)

目的:探讨海绵肾肾结石经皮肾镜钬激光碎石取石的疗效及安全性。方法:回顾性分析我院2009年1月~2016年1月住院治疗的30例海绵肾合并肾结石并行经皮肾镜钬激光碎石取石治疗的患者,术后观察患者临床疗效。结果:30例均成功去大部分游离结石,解除上尿路梗阻,术后复查KUB平片结石均较术前明显减少。结论:引起肾盂输尿管上段梗阻的海绵肾肾结石可行经皮肾镜取石术,只需要清除引起梗阻的游离结石,部分黏膜下较大结石也可碎石清除。不主张进行较大面积的干扰髓质内结石。

Objective：To discuss the curative effect and safety of holmium laser lithotripsy of percutaneous nephrolithotomy in treating medullary sponge kidney.Method：Thirty cases with medullary sponge kidney complicated with kidney stone who were admitted and treated in affiliated hospital of Zunyi Medical College from Jan.2009 to Jan.2016 had been retrospectively analyzed,and the clinical curative effect of patients had been observed after the operation.Result：All of 30 cases had their free stones mostly removed,and their upper urinary tract obstruction relieved.It was revealed by the postoperative reexamination of KUB plain film that all of their calculi had been significantly reduced as compared to pre-operation.Conclusion：The case of medullary sponge kidney stone that causes the upper pelviureteric tract obstruction can be performed with percutaneous nephrolithotomy.Only the free calculus that causes the obstruction need to be removed,and part of the relatively large submucous calculi can also be removed by lithotripsy.It is not recommended to extensively disturb the intra-medullary calculus.