微通道镜经皮肾镜碎石取石术一期治疗无积水肾结石疗效观察

Clinical effect of microchannel percutaneous nephrolithotripsy in the treatment of renal calculi without hydronephros

目的探讨微通道经皮肾镜碎石取石术(mPCNL)治疗无积水肾结石的临床效果。方法回顾性分析2019年6月至2021年6月海南医学院第二附属医院泌尿外科采用mPCNL治疗112例无积水肾结石患者的临床资料,其中左肾52例,右肾60例;完全性铸型结石68例,不完全性铸型结石33例,孤立性结石11例。结果112例患者均在B超引导下精准穿刺建立F16微通道并施行一期单通道碎石,手术平均时间(62.31±12.54)min,术后血红蛋白平均下降(9.3±2.4)g/dL,术后3 d结石清石率为83.93%,术后1个月结石清石率为90.17%,7例患者需输血治疗,术后发热9例,经抗感染治疗后体温均降至正常;无尿漏、气胸、周围脏器损伤等严重并发症发生。结论微通道经皮肾镜钬激光碎石取石术治疗无积水肾结石具有结石清石率高、安全有效的特点。

Objective To investigate the clinical effect of microchannel percutaneous nephrolithotripsy(MPCNL)in the treatment of renal calculi without hydronephrosis.Methods The clinical data of 112 patients with renal calculi without hydronephrosis treated by mPCNL in Department of Urology,the Second Affiliated Hospital of Hainan Medical University from June 2019 to June 2021 were retrospectively analyzed.Among then,there were 52 cases of left kidney and 60 cases of right kidney.There were 68 cases of complete cast stones,33 cases of incomplete cast stones,and 11 cases of isolated stones.Results All 112 patients underwent precise puncture to establish F16 microchannel under the guidance of B-ultrasound and performed one-stage single-channel lithotriptomy.The average operation time was(62.31±12.54)min,and the average postoperative hemoglobin decreased(9.3±2.4)g/dL.The stone clearing rate was 83.93%at three days after surgery and 90.17%at 1 month after surgery.Blood transfusion was needed in 7 patients,and postoperative fever occurred in 9 patients,with body temperature decreased to normal after anti-infective treatment.No serious complications such as urine leakage,pneumothorax,and injury of surrounding organs occurred.Conclusion Microchannel percutaneous nephrolithotripsy in the treatment of renal calculi without hydronephros brings high stone removal rate and is safe and effective.