微创经皮肾镜取石术治疗结石性脓肾(附23例报告)

目的探讨微创经皮肾镜取石术(MPCNL)治疗结石性脓肾的可行性和安全性。方法23例结石性脓肾患者,Ⅰ期行微创经皮肾穿刺造瘘术后Ⅱ期行MPCNL。结果23例患者Ⅰ期行微创经皮肾穿刺造瘘术成功率100%,Ⅱ期行MPCNL结石取净率87%(20/23),3例术后结合体外冲击波碎石术(ESWL)治愈;术后随访患肾功能恢复或部分恢复21例(91%),术后发生肾萎缩2例(8.6%),无1例需行肾切除术。结论MPCNL治疗结石性脓肾患者安全有效,保肾率高。

Treatment for calculous pyonephrosis with minipercutaneous nephrolithotomy(a report of 23 cases)

[Objective] To investigate the efficiency and safety of kidney sparing operation by mini-percutaneous nephrolithotomy(MPCNL)in the treatment of calculous pyonephrosis.[Methods] 23 cases of calculous pyonephrosis were treated by percutaneous nephrostomy in the first stage,and then by MPCNL.[Results] The rate of percutaneous nephrostomy in the first stage attained to 100%.20 cases achieved stone-free(87%),and 3 cases with residual calculi were treated by ESWL.The renal function returned to some extent in 21 cases(91%).Renal atrophy was observed in 2 cases(8.6%).No case needed nephrectomy.[Conclusions] MPCNL is a safe and efficient method for the treatment of calculous pyonephrosis.The rate of kidney saving is very high.