微创经皮肾穿刺取石术治疗复杂性肾结石疗效分析

目的探讨微创经皮肾穿刺取石术（MPCNL）治疗复杂性肾结石的安全性和效果。方法回顾性分析自2007年4月-2011年3月,以EMS-Ⅲ气压弹道碎石机行微创经皮肾穿刺取石术治疗复杂性肾结石35例患者的临床资料。结果 35例患者中,31例I期手术成功,4例结石残留,辅以体外冲击波碎石（ESWL）治疗。结石总取净率为88.6%。手术时间为60～137 min,平均94 min;碎石取石时间15～73 min,平均35 min。术后肾造瘘管留置时间平均7 d,平均住院时间11.6 d。未发生严重并发症。结论微创经皮肾穿刺取石术具有损伤小、恢复快、住院时间短、结石清除率高、并发症少等优点,是治疗复杂性肾结石较好的微创方法。

Minimally Invasive Percutaneous Nephrolithotomy for Complex Renal Calculi

Objective To evaluate the clinical effect and safety of minimally invasive percutaneous nephrolithotomy（MPCNL） for complex renal calculi.Methods The data of 35 patients with complex renal calculi who underwent minimally invasive percutaneous nephrolithotomy with pneumatic lithotripter（EMS-Ⅲ） from April 2007 to March 2011 were analyzed retrospectively.Results Of the 35 cases,31 succeeded with one-stage operation,4 had a residual ston,and accessory therapy of extracorporal shock wave lithotripsy（ESWL） was performed for the above 4 patients.The total stone-free rate was 88.6%.The operative duration was 94 min（ranging from 60 to 137 min）,the time for complete stone clearance was 35 min（ranging from 15 to 73 min）,average postoperative nephrostomy tube stay was 7 days,and average hospitalization stay was 11.6 days.No major complications were noted in the patients.Conclusion Minimally invasive percutaneous nephrolithotomy has the advantages of fewer invasions,rapid recovery,short hospitalization stay,high stone-free rate,and fewer complications.It＇s a good minimally invasive procedure for complex renal calculi.