B超引导下微创经皮肾镜治疗孤立肾肾结石

目的探讨B超引导下微创经皮肾镜治疗孤立肾结石的疗效及安全性。方法回顾性分析2009年1月—2010年12月接受B超引导下行微创经皮肾镜手术治疗16例孤立肾结石患者的临床资料,所有患者采用单通道碎石,术中留置肾造瘘管及双J管,术后随访患者结石清除率,血清肌酐,尿素氮,有无新发高血压。结果 12例患者一期手术清除结石,2例患者二期手术清除结石,2例患者二期手术后有结石残留行体外冲击波碎石后清除结石,1例患者术后迟发性出血,经高选择性介入栓塞治疗治愈,无重大并发症,随访1年,患者肾功能改善,无结石复发及新发高血压患者。结论微创经皮肾镜治疗孤立肾肾结石成功率和并发症发生率与非孤立肾患者相同,是安全有效的治疗方式。

Minimally Invasive Percutaneous Nephrolithotomy Under Ultrasound for Calculi in Patients with Solitary Kidney

Objective To evaluate minimally invasive percutaneous nephrolithotomy in the patients with solitary kidneys. Methods From January 2009 to december 2010,16 patients with kidney calculi in solitary kidneys underwent minimally invasive percutaneous nephrolithotomy, the date was reviewed retrospectively. Results The calculi were extracted successfully in 12 patients after the first session, 2 patients after the second session, 2 patients were treated by ESWL after the second operation. 1 patient had delayed hemorrhage were cured by angiography and embolization, no major complications occurred, by the end of follow-up there was no new onset hypertention, and renal function improved significantly, no caculi recurrence. Conclusion The rate of success and complications seem to be similar to the double kidney, minimally invasive percutaneous nephrolithotomy is not only effective but is also safe in the solitary kidney with calculi.