B超引导下经皮微通道输尿管镜碎石治疗上尿路结石

目的：探讨超声引导下微创经皮输尿管镜取石术（MPCNL）在上尿路结石治疗中的临床疗效及其应用价值。方法：回顾性分析超声引导下微创经皮输尿管镜取石术128例临床资料。结果：128例患者中,一期取净结石90例,二期取净结石19例,中转开放手术1例;20例术后2月仍有残留结石,行体外冲击波碎石（ESWL）后排净。平均手术时间120 min,平均出血量80 mL,平均住院8 d,该组结石取尽率达85.2%;术后无继发性出血、尿外渗、肾盂输尿管穿孔及气胸、腹腔脏器损伤等严重并发症发生。结论：超声引导下行MPCNL治疗上尿路结石具有微创、高效、安全和并发症少等优势,患者术后恢复快,具有临床推广应用价值。

Minimally Invasive Percutaneous Nephrolithotomy with Ultrasound Guidance for Treatment of Upper Urinary Calculi

Objective：To evaluate the clinical effect and explore the value of treatment of upperurinary calculi with minimally invasive percutaneous nephrolithotomy under the guidance by B-ultrasound. Methods：The clinicaldata of 128 cases with upper urinary lithiasis who underwent MPCNL were analyzed retrospectively. Results：90 cases presented stone free after the first MPCNL,19 after the second one,and 1 resorted to open surgery.The other 20 cases still had residual stones 2 months after operation,and after ESWL they were stone free.Mean operating time was 120min,meanamount of bleeding 80mL,mean hospital stay 8 days.The stone-free rate was 85.2%.There were no secondary postoperative bleeding,urine leakage,ureter or renal pelvis perforation,pneumothorax,abdominal organ damage and other complications. Conclusions：Less trauma,high success rate,safe and less complications are the merits of MPCNL with ultrasound guidance.It is an ideal method in the treatment of calculus in upper urinary and wort-hwhile to be widely used in clinical.