复杂性肾结石治疗方法的比较

目的：探讨复杂性肾结石的首选治疗方法。方法：分别应用ESWL、开放手术、经皮肾镜取石术（PCNL）及微创经皮肾镜取石术（MPCNL）治疗复杂性肾结石患者132例，并随访观察其疗效及并发症发生率。结果：采用ESWL治疗56例，3个月后结石排净率53．6％；采用开放手术治疗37冽，手术均获成功，结石排净率达96％；采用PCNI。治疗39例，3个月后结石排净率为92％。结论：PcNL＋MPCNL＋ESWL为复杂性。肾结石的首选治疗方法，可适合于绝大部分复杂性肾结石患者，其中ESWI。适用于无肾盂肾盏扩张的复杂性且硬度较低的肾结石。开放手术可作为其他治疗方法的适当补充术式。

Comparison of Management of Complexity Kidney Calculi

Objective： To investigate the preferred management of complexity kidney calculicas. Methods： 132 patients with complexity kidney calculi were treated by extraeorporeaI shock wave lithotripsy （ESWL）, open sur gery, pereutaneous nephrolithotomy （PCNL） and minimally invasive percutaneous nephrdithotomy （MPCNL）re spectively. Then the therapeutic effect and complication were analysed. Results： 56 cases were treated by ESWL, stone free rate was 53.6% after 3 monthes follow up. 37 cases were treated by open surgery, stone free rate was 96%. 39 cases were treated by PCNL, stone free rate was 92%. Conclusions：PCNL＋ MPCNL＋ ESWL should be the first line therapeuticm ways for patients with complexity kidney calculi. ESWL could be used for part of complexity kidney calculi cases with normal renal anatomy combined with low density. And open surgery is a appropriate way when the staghorn calculi could not be managed by PCNL or ESWL.