微创经皮肾穿刺取石术治疗肾结石

目的：探讨微创经皮肾穿刺取石术(微创PCNL)治疗肾结石的疗效。方法：采用微创PCNL治疗的235例肾结石患者，肾结石长径为1．5～1．7cm，单发性结石150例，多发性结石85例。其中鹿角状结石60例，双侧肾结石40例，孤立肾并肾结石9例，有开放手术史23例。结果：235例均行一期穿刺取石，其中1次取石183例，2次以上取石52例；单通道取石198例，多通道取石37例，结石清除率85％。手术时间平均2h；术中、术后有明显出血7例(3％)，均经保守治疗治愈，平均住院时间10d。结论：微创PCNL是一种有效的治疗肾结石的方法，创伤小，恢复时间短。

Treatment of renal calculi with minimally invasive percutaneous nephrolithotomy

Objective:To evaluate the efficiency of minimal invasive percutaneous nephrolithotomy in treating renal calculi.Method:We retrospectively investigated 235 patients with renal calculi who were treated with minimally invasive percutaneous nephrolithotomy from July 2001 to June 2003. Of 235 cases, the diameter of the stone is from 1.5 cm to 1.7 cm, sole calculus in 195 cases, multiple calculi in 85 cases, respectively. Simutaneously, staghorn calculi in 60, bilateral renal calculi in 40, solitary kidney in 9, and 23 cases had ever received open nephrolithotomy.Result:All cases were performed one-stage procedure, one session procedure in 183, 2 sessions or more in 52. Single tract in 198, multiple tracts in 37, respectively. The stone-free rate was 85%. Average operative time was 2 hours. Only 7 cases suffered from massive hemorrhage intraoperatively or postoperatively, who were managed by conservative treatment. The mean hospitalization time was 10 days.Conclusion:Minimally invasive PCNL is an effective technique in renal calculi treatment. The patients had less morbidity and quickly return to preoperative activity.