微创经皮肾镜取石术10肋间治疗上尿路结石

目的 对微创经皮肾镜取石术（MPCNL）10肋间治疗上尿路结石的安全性与疗效进行探讨。方法 对该院2000年至今行MPCNL10肋间治疗的41例病例进行回顾性分析。结果 41例中40例手术成功，均为单通道取石，成功率为97．6％。35例一期结石取尽，一期取尽率85．4％。6例一期未取尽，其中1例残余结石对肾功能影响不大未进一步处理，2例行ESWL处理，术后1月结石排尽，另3例行同一通道Ⅱ期取石，1例取尽，2例未取尽但已解除梗阻对肾功能影响不大，未进一步处理。1例多发性肾结石患者术中因筋膜扩张器脱出形成血尿气胸，给予胸腔闭式引流术，结石经12肋间行MPCNL取出。结论 经皮肾镜取石术经10肋间治疗上尿路结石是安全有效的。

Treatment of upper urinary calculi with minimally invasive percutaneous nephrolithotomy via 10th rib

[Objective] To evaluate the feasibility and safety of treating upper urinary calculi with minimally invasive percutaneous nephrolithotomy(MPCNL) via 10th Rib. [Methods] We retrospectively analysed 41 cases (21male and 20 female, aged range from 18 to 68 and average age is 38.2)with MPCNL via 10th Rib. [Result] Among 41 cases, there were 40 cases succeeding in single channel, which include 35 cases succeeding in first stage with the success rate of 85.4%. 3 cases succeed in second stage and 2 cases proceed ESWL after MPCNL, the total success rate is 97.6%. One case had hematuria pneumothorax for the prolapsus of the dilator during the first operation, the calculi remains were picked out with MPCNL via 12th rib space after received the operation of closed thoracic drainage. [Conclusion] MPCNL via 10th rib is safe and feasible comparatively.