X线定位微创经皮肾穿刺造瘘取石术治疗肾结石及输尿管上段结石的临床疗效观察

目的探讨X线定位微创经皮肾穿刺造瘘取石术（MPCNL）治疗肾结石及输尿管上段结石的安全性及有效性。方法回顾性分析我院2007年10月～2010年11月采用X线定位MPCNL术治疗肾结石及输尿管上段结石150例患者的资料,对皮肾通道穿刺成功率、手术时间、术中出血量、结石清除率及术后并发症进行分析。结果本组病例均为单通道取石,建立皮肾通道成功率为100%,Ⅰ期碎石术124例,Ⅱ期碎石术25例,Ⅲ期碎石术1例,总结石取尽率为88%,手术时间0.8～3.0 h,平均1.8 h,术中出血量20～250 mL,除1例发生术后肾出血外,无其他严重并发症发生。结论微创经皮肾穿刺造瘘取石术（MPCNL）治疗肾结石及输尿管上段结石安全有效。

The clinical effect of minimally invasive percutaneous nephrolithotomy under X-ray guaidance in treatment of renal calculus and upper urinary calculus

Objective To investigate the efficacy and safety of minimally invasive percutaneous nephrolithotomy under X-ray guaidance in treatment of renal calculus and upper urinary calculus.Methods 150 patients with renal calculus and upper urinary calculus from October 2007 to November 2010 in our hospital treated by MPCNL under X-ray guidance were retrospectively analyzed.The results of success rate of skin biopsy of renal channel,operation time,peri-operative bleeding,clearance rate of stones and postoperative complications were analyzed.Results The single percutaneous-renal channel was successfully established in all patients.One-stage operation were 124 cases,two-stage were 25 cases,three-stage was 1 case.The total clearance rate of stones was 88%.The average time of operation was 0.8-3.0 h,with the average of 1.8 hours.The estimated volume of blood lose was 20～250 mL.There were not seriously complications except 1 case of kidney hemorrhage after MPCNL.Conclusion Minimally invasive percutaneous nephrolithotomy in treatment of renal calculus and upper urinary calculus is effective and safe.