摘要
目的探讨微创经皮肾镜取石术(MPCNL)治疗重复肾输尿管结石的临床应用价值。方法采用B超定位下MPCNL治疗30例重复肾、输尿管结石患者。男性12例,女性18例。平均年龄38(18～66)岁。30例均由静脉尿路造影及CT确诊。上位肾结石4例、下位肾结石19例(其中鹿角形结石6例)、输尿管交汇处结石7例。结石平均直径3.4(2.5～4.7)cm。结果30例均成功建立经皮肾通道,平均手术时间70(30～120)min。术中平均出血30(5～60)ml,均未输血。结石一期清除率90%(27/30),3例有少许残石者1月后行体外冲击波碎石(ESWL)后结石排净。术后无继发出血、无发热。随访12～24个月,结石无复发。结论MPCNL治疗重复肾结石具有手术时间短、出血少、结石清除率高、术后并发症少等优点,安全有效。
Objective To discuss the clinical efficacy of minimally invasive percutaneous nephrolithotomy （MPCNL） for calculi in duplex kidney and ureter. Methods The clinical data of 30 cases （12 males and 18 females） treated by MPCNL were retrospectively analyzed. The mean age was 38 years （ranged from 18 to 66 years）. All the 30 cases Were finally diagnosed by intravenous urography and CT. Supra- renal calculi were in 4 cases, hypo- renal calculi in 19 cases （including 6 cases of staghorn calculi） and calculi in ureteral confluence were in 7 cases. The mean diameter of stone was 3.4 cm （ranged from 2.5cm to 4.7cm）. Results All puncture procedures were performed in a standard one session technique with Bultrasonography whole range guidance in 30 cases. The operative time ranged from 30min to 120min （mean 70min）. Bleeding amount ranged from 5ml to 60ml （mean 30ml） and no case needed for blood transfusion. The stone free rate was 90% （27/ 30） at one- stage. Leftover calculus in 3 cases was treated by extracorporeal shock wave lithotripsy （ESWL） and removed completely. No postoperative bleeding or fever occurred. All the 30 cases were followed up for 12 to 24 months. No calculus had recurrence. ConcluSions MPCNL is safe and effective in treatment of renal calculi in duplex kidney, with the advantages of short operation time, little hemorrhage volume, high stone-free rate, low complication rate, and so on.
出处
《实用预防医学》
CAS
2009年第4期1202-1203,共2页
Practical Preventive Medicine
关键词
微创经皮肾镜取石术
结石
重复肾
Minimally invasive percutaneous nephrolithotomy
Calculus
Duplex kidney
