经皮肾穿刺造瘘碎石术治疗鹿角形肾结石

目的 探讨肾脏鹿角形结石的经皮肾穿刺造瘘碎石术(percutaneous nephrolithotomy,PCNL)治疗及注意事项.方法 回顾总结158例行PCNL治疗,以及PCNL结合体外冲击波碎石(extracorporeal shock-wave lithoclasty,ESWL)治疗的肾脏鹿角形结石患者.结果 一期PCNL清除结石64例,结合ESWL 73例,2次以上PCNL 46例,结石清除率83.5%,术中术后发生休克13例,发热9例,肉眼血尿者47例(5例患者因严重肉眼血尿而拔除双J管),耻骨上区、腰腹部不适及肾绞痛23例(4例患者经对症治疗无好转而拔除双J管).结论 PCNL是肾鹿角型结石的有效治疗方法,术中术后应密切注意患者全身情况

Percutaneous nephrolithotomy for staghorn nephrolithiasis

Objective To report the experience of percutaneous nephrolithotomy(PCNL)in the treatment of staghorn nephrolithiasis.Methods Totally 158 patients with staghorn nephrolithiasis treated by PCNL or together with extracorporeal shock-wave lithoclasty(ESWL)were retrospectively reviewed.Results Sixty-four patients were well cured with one-staged PCNL,73 with PCNL plus ESWL,and 46 with more than two-staged PCNL.Stone clearance rate was 83.5%.The complications included shock in 13 patients,fever in 9,gross hematuria in 47,discomfort in 23,postoperative removal of double pigtail stents in 9(5 due to serious hematuria,4 for unendurable discomfort).Conclusion PCNL is an effective surgery for staghorn calculus,however the occurrence of shock should be paid attention to.