微创经皮肾镜取石术治疗上尿路结石 (附426例报告)

目的 探讨微创经皮肾镜取石术(miniPCNL)治疗上尿路结石的疗效及作用。方法 从2000年5月～2004年12月应用minj PCNL技术治疗上尿路结石426例。结果 426例中有351例Ⅰ期取石，69例行Ⅱ期取石，6例行Ⅲ期取石，其中单通道取石363例，双通道取石58例，三通道取石5例，平均结石清除率90．18％，平均手术时间86min，肾造瘘管平均留置6天。平均住院12d，术中均未输血，其中2例术后并发迟发性大出血，经高选择性肾动脉栓塞治愈。3例术后出现尿外渗，经调整肾造瘘管位置及置入外支架管后治愈，其它随访未出现明显并发症。结论 mini PCNL治疗上尿路结石安全、高效，具有对患者创伤小、恢复快，结石清除率高等优点，是治疗上尿路结石的一种好方法。

Treatment of calculus in upper urinary tract with miniaturised instrument for percutaneous nephrolithotomy (report of 426 cases)

Objective] To evaluate miniaturised instrument for percutaneous nephrolithotomyin upper urinary. Methods] 426 patients underwent miniaturised instrument for percutaneous nephrolithotomy for calculus in upper urinary tract from May 2000 to December 2004 were reviewed and evaluated. Results] 351 patients were rendered stone-free at 1 session; 69 patients were rendered stone-free at 2 session; 6 patients were rendered stone-free at 3 session.363 cases were operated through single-road; 58 cases were operated through double-road and 5cases were operated though tri-road. The stone free rate were 90.18%; the mean time of operation was 86 min; the mean time of the nephrostomy tube was 6 days; the average hospitalization was 12 days. No one needed intraoperative blood transfusion. 2 cases had postioperative delayed severe bleeding and were cured by the mean of super-select renal arteriographic embolization; 3 cases were complicated with postoperation urinary fistula and were cured by adjusted the location of the nephostomy tube. The rest patients had no obvious complications. Conclusions] The miniaturised instrument for percutaneous nephrolithotomy of the treatment of calculus in upper urinary tract was claimed to be safe and less trauma and a high success rate, miniaturized instrument for percutaneous is a ideal method in the treatment of calculus in upper urinary.