多通道微创经皮肾取石术治疗孤立肾肾结石

目的：探讨多通道微创经皮肾取石术(MPCNL)治疗孤立肾肾结石的安全性与有效性。方法：经皮肾通道扩张至F14～F16，用小口径的输尿管硬镜(通常为F8／F9．8)替代肾镜，采用多通道取石．利用高压灌注泵的脉冲水压，冲出小碎石。结果：38例患者中，5例先行经皮肾穿刺造瘘术，5～7d后行二期PCNL，其余33例患者均行一期取石。所有患者为1～3通道取石，结石清除27例(86％)。1例孤立肾肾结石合并积脓，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，其余未发现严重并发症。结论：采用多通道取石可以克服单通道难以取出平行于通道的盏石的缺点，提高结石清除率，减少术中出血，加快结石取出速度。

Treatment Of Solitary Kidney Calculi With Minimally Invasive Percutaneous Nephrolithotomy

Objective:To assess the safety and feasibility of minim al ly invasive percutaneous nephrolithotomy(MPCNL)in treatment of solitary kidn ey calculi.Methods:The nephropathy was extended to F14-F16 through invasive pe rcutaneous.A small size of ureterscope(F8/F9.8)was used to take stones and the c rushed stones were pushed out by pulse water pressure.Results:Among 38 cases,5 w ere pretreated by percutaneous nephropancture and treated secondary PCNL.The res t 33 cases were treated with first PCNL.One to three tracts were used in all cases.There were 27 cases(86%)showed stone-free after treated with one-stag e minimally invasive percutaneous nephrolitho tomy.Only one case with pyonephr osis suffered from postoperative infect appeared shock while one-stage min imally invasive percutaneous nephrolithotomy.Another one with diabetes suffered from postoperative ketoacidosis,no major complications were noted in other p atients.Conclusion:Minimally invasive percutaneous nephrolithotomy is safe an d effective in treating solitary kidney calculi,compared to traditional PCNL.It may offer advantages with respect to less invasion and easy recovery.