微创经皮肾镜取石术治疗孤立肾肾结石

TREATMENT OF SOLITARY KIDNEY CALCULI WITH MINIMALLY INVASIVE PERCUTANEOUS NEPHROLITHOTOMY

目的 :为了探讨F14～F16微创经皮肾镜取石术 (MPCNL)治疗孤立肾肾结石的安全性与有效性 ;方法 :从 1998年 1月～ 2 0 0 3年 5月 ,利用微创PCNL技术治疗孤立肾肾结石 2 8例。结果 :2 8例患者中 ,合并肾积脓 6例 ,5例先行经皮肾穿刺造瘘术 ,5～ 7d后行二期经皮肾镜取石术 ,其余 2 3例患者均行一期取石 ,所有患者均为单通道取石 ,结石清除率 2 4例 ( 86% )。 1例孤肾肾结石合并积脓 ,行一期取石 ,术后出现中毒性休克 ,1例合并糖尿病患者术后出现酮症酸中毒 ,其余未出现大的并发症。结论 :微创PCNL治疗孤立肾肾结石是安全、有效 ,同时具有对病人创伤小 。

Objective:To assess the safety and feasibility o f minimally invasive percutaneous nephrolithotomy (mPCNL) in treating solitary k idney calculi.Method:We retrospectively investigated 28 patients with solitar y kidney calculi, who were treated with minimally invasive percutaneous nephrol ithotomy from January 1998 to May 2003.Results:Of 28 cases, 86% stone-free rate was achieved usi ng one-stage minimally invasive percutaneous nephrolithotomy. Single tract was i n all cases. Only one case with pyonephrosis suffered from postoperative infect shock while one- stage minimally percutaneous nephrolithotomy.Another one with diabetes suffered from postoperative ketoacidosis, no major complications were n oted in the other patients.Conclusions:Minimally invasive percutaneous nephrolithotomy is s afe and effective in treating solitary kidney calculi,compared to traditional P CNL,it may offer advantages with respect to less invasion and easy recovery.