预留导丝在复杂性肾结石行经皮肾镜术中的应用

目的探讨预留导丝在复杂性肾结石行经皮肾镜碎石取石术（PCNL）中的应用价值。 方法2014年5月至2017年9月我院术前评估为复杂性肾结石患者63例，其中鹿角形结石34例，结石平均大小（4.8±1.8） cm，多发性结石29例，分布肾盏个数（8.2±4.2）个。在建立通道前视结石分布情况，预留导丝并固定，然后根据保留的导丝建立经皮肾通道行PCNL术。 结果一期手术完全清除结石52例，清除率为82.6%；二期手术11例，总手术清除率为95.1%，手术时间、住院时间分别为（83.5±40.8） min、（8.2±3.7）d，所有病例均无胸膜、肠管、肝脾等脏器损伤，无输血及肾血管栓塞等病例。 结论对于复杂性肾结石，预留导丝可以简化操作步骤、精准穿刺目标肾盏，有利于提高PCNL的结石清石率，缩短手术时间，值得临床推广。

Application of reserved guide wire in percutaneous nephrolithotomy for treatment of complicated renal calculi

ObjectiveTo explore the application value of reserved guide wire in percutaneous nephrolithotomy (PCNL) for complex kidney calculi. MethodsFrom May 2014 to September 2017, 63 patients with complex kidney stones were evaluated in our hospital, including 34 cases of staghorn stones with a mean size of (4.8±1.8) and 29 with multiple stones. The distribution of kidney calculi was observed before the establishment of the channel. A guide wire was reserved and fixed, and then a percutaneous renal channel was established according to the reserved guide wire for PCNL. ResultsThe kidney calculi were completely removed by one-stage operation in 52 cases (82.6 %). Eleven patients underwent the second-stage operation with a total removal rate of 95.1%. The operation time was (83.5±40.8) min and the length of hospital stay was (8.2±3.7) d. No pleural, intestinal canal, liver and spleen injuries occurred. No blood transfusion and renal vascular embolism were observed. ConclusionFor patients with complex kidney calculi, the reserved guide wire can simplify the surgical procedures, accurately puncture the kidney calices, improve the calculi removal rate of PCNL and shorten the operation time, which is worthy of clinical promotion.