微创经皮肾穿刺取石术在肾结石治疗中的应用(附65例报告)

目的探讨应用微创经皮肾穿刺取石术在肾结石中的疗效.方法对65例肾结石的患者采用微创经皮肾穿刺输尿管镜碎石取石术将肾结石粉碎并取出,术后3-5天拔除肾造瘘管,4周后拔除输尿管内留置的D-J管.结果行微创经皮肾穿刺输尿管镜碎石取石术治疗肾结石65例,一期取净结石41例,二期取净结石15例,结石取净率86.1%,9例残留结石行体外冲击波碎石治疗后排出.肾盂梗阻解除率100%,手术时间60～210分钟,平均110分钟.术中出血约50-200ml,平均150ml,均无术中输血,未发现严重并发症.结论微创经皮肾穿刺取石术治疗肾结石,具有结石取净率高,损伤小,出血少,恢复快等优点,是治疗肾结石的一种好方法.

Application of mini-percutaneous nephrolithotomy in the treatment of kidney calculi

Objective To assess the efficacy of minimally invasive percutaneous nephrolithotomy in treating kidney calculi. Methods A total of 65 patients was diagnosed as kidney calculi, all received minimally invasive percutaneous nephrolithotomy. The average nephrostomy tube indwelling time was 3-4 days, average retention time of D-J tube was 4 weeks. Results Data of 65 patients underwent mini PCNL for kidney calculi were reviewed and evaluated. The stones were cleared off at one section in 41 cases, two sections in 15 and other 9 cases received auxiliary extracorporeal shock wave lithotripsy after two sections, the stone-free rate was 86.1% (56/65). The average operation time was 110 minutes, average blood loss volume was 150ml, blood transfusion was not needed in all patients, no major complication was noted. Conclusions MPNL offers advantages of high stone free rate, less invasion, less bleeding, easy recovery, and less complications, it is a more effective method for the treatment of kidney calculi.