经皮肾腔内肾乳头活检技术的建立及临床意义

目的：借助微创经皮肾穿刺取石术（MPCNL）建立经皮肾引导直视下进行肾乳头活检的技术,为尿结石病因的基础研究提供新的途径.方法：2005年5月～2007年10月对12例复杂肾结石行MPCNL,对术中发现已有肾乳头钙化斑形成的患者采用经皮肾引导直视下进行肾乳头活检,肾乳头活检标本送电镜观察.结果：12例患者术后无一例出现严重血尿、肾出血的并发症,无一例因严重并发症而再次手术或介入治疗,手术后随访肾功能恢复良好.结论：经皮肾腔内肾乳头活检技术安全、可行,能够在直视条件下获取肾乳头钙化斑组织进行形态学以及蛋白或基因水平的研究,为将来尿结石形成的基础研究提供了一条新的途径.

Endoscopic Renal Papillary Biopsies Technique and it's Signification in Basic Studies in Patients With Nephrolithiasis

Objective： To establish an endoscopic renal papillary biopsy technique in order to obtain papillary tissue from calcium stone formers during the course of minimally invasive percutaneous nephrolithotomy （MPC NL）. Methods： From May 2005 to October 2007, 12 consecutive patients undergoing PCNL for stone extraction were selected, biopsies from select papillae in the peripheral and interpolar regions were obtained with 5Fr flexible biopsy forceps during MPCNL. The biopsied tissues were submitted for scan electron microscopy analysis. Results： All patients had successful biopsy completion, no complications were attributable to the biopsy process, and none patients developed severe haemorrhage after biopsy requiring re operation or intervention treatment. Conclusions.. Endoscopic papillary biopsies through PCNL was a safe method in patients with kidney calculi. Tissue ob rained using this protocol can be used for detailed histological and analytical studies, which may lead to significant advances in our understanding of stone formation mechanisms.