微创经皮肾穿刺钬激光碎石治疗肾结石

目的探讨局麻下微创经皮肾穿刺钬激光碎石治疗肾结石的效果。方法对34例肾结石采用局麻下超声引导MPC—NL，建立通道后通过输尿管镜／肾镜探查结石，钬激光粉碎及取石。结果采用B超引导下MPCNL钬激光碎石治疗的复杂性肾结石34例。34例中一次取净结石30例，二次取净结石4例，结石总取净率85．0％。平均手术时间90min（60～150min），平均术中出血150mL（80～350mL），2例输血400mL。一次取石患者平均住院时间7d（5～10d）。术中并发大出血2例，水中毒1例。结论B超引导下MPCNL辅以钬激光碎石，是治疗肾结石的一种简便、安全、有效的方法。

Study of Minimally Invasive Percutaneous Nephro-lithotomy in Patients with Renal Calculi

Objective To study the clinical experiences of the minimally invasive percutaneous nephrolithotomy treatment on renal calculi under local anesthesia. Methods A total of 34 patients with complicated renal stone treated with MPCNL under the guide of B-ultrasound. Results 30 patients were treated successfully in the first one session, the total stone clearance rate was 85%. The average operative time was 90 min（range 60-150 min）. Mean estimated blood loss was 150mL（range 80-350mL） and 2 cases need blood transfusion. Mean hospital stay was 7 days（range 5-10 days）. The main complication were hemorrhea（2 cases）and overhydration（ 1 case）. Conclusion Under the guide of B-ultrasound, MPCNL with holmium：YAG laser is a simply, safe and effective method for managing complicated renal stone.