【摘要】 目的探讨鹿角形肾结石微创经皮肾镜穿刺取石术的安全性及清石率。方法 2004年5月至2009年2月通过微创经皮肾镜穿刺取石术对125例鹿角形肾结石治疗。所有患者术前均行B超、KUB、IVP、CT、中段尿培养等检查,术前预防性使用抗生素3 d,术中严格控制灌注泵流量(360～400 mL.min-1)、灌注液温度(26℃左右)。同时应用B超、C臂机X线复查是否有残留结石。结果 86例取净,取净率68.8%,其中1次取净74例59.2%,同一通道2次取净7例5.6%,同一通道3次取净1例0.8%,另行穿刺通道2次取净4例3.2%。所有患者无一例术后出现败血症,无一例血管栓塞,2例输血。结论微创经皮肾镜穿刺取石术是鹿角形肾结石高效、安全的治疗手段,术前的充分准备、术中的细心操作及穿刺途径的选择是手术成功的关键。更多还原

【Abstract】 Objective To explore the security and stone clearance rate of minimally invasive percutaneous nephrolithotomy(MPCNL) for renal staghorn calculi.Methods 125 patients with renal staghorn calculi were treated with MPCNL from May 2004 to February 2009.All patients underwent preoperative BUS,KUB,IVP,CT,midstream urine culture,and prophylactic antibiotics for 3 days.The infusion pump flow rate(360 ～ 400 mL·min-1) and infusion fluid temperature(±26 ℃) were instrictly controlled during operation.The residual stone was examined with BUS and C arm X ray.Results The stones were completely cleared in 86 patients(68.8%),including 74 patients(59.2%) with one time single tunnel,7 patients(5.6%) with two times single tunnel,1 patient(0.8%) with three times single tunnel,4 patients(3.2%) with two times double tunnel.There were no severe complications such as septicemia and vascular embolization in all patients.Two patients needed blood transfusion.Conclusion MPCNL is an effective and safe treatment for renal staghorn calculi.The sufficient preoperative preparation,careful operation and puncture channel selection are the keys for successful operation.更多还原