【摘要】 目的评价B超引导微创经皮肾镜术(MPCNL)治疗上尿路结石的疗效。方法回顾性分析本院153例上尿路结石患者采用B超引导微创经皮肾镜术治疗的临床资料。结果 2例建立通道后发现出血量大,放置肾造瘘管后夹闭,改行二期MPCNL;结石一期手术清除率为93.4%(143/153),平均手术时间126min(35～367min),平均住院时间9d(5～23d)。10例残余结石者,其中2例7d后由原通道进镜碎石成功,7例辅助1～2次体外冲击波碎石(ESWL)治疗,1例2次MPCNL治疗。1例术后3d拔除肾造瘘管出现大出血,经局部压迫、输血、制动、使用止血药物等处理后血止。1例合并糖尿病患者出院后7d出现高热,体温40.5℃,予拔除输尿管支架,应用广谱抗生素,3d后体温正常。结论 B超引导微创经皮肾镜术治疗上尿路结石是安全、有效的。更多还原

【Abstract】 Objective To evaluate the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) with B ultrasound guidance in treating upper urinary tract calculi.Methods The clinical data of 153 patients with upper urinary tract calculi who had undergone MPCNL were retrospectively analyzed.Results Hemorrhage was found in 2 patients after building channel who had treated by second MPCNL after placing and clipping renal fistula.The calculi clearance rate was 93.4%(143/153);the average operative duration was 126 minutes(35-367 min);the mean hospital stay was 9 d(5-23 d).In 10 patients with residual calculi,there were 2 patients who had treated successfully through the original channel 7 days later;there were 7 patients who had treated auxiliarily by ESWL for 1-2 times;there was 1 patient who had treated by second MPCNL.Hemorrhage was found in 1 patient when removing the renal fistula at the third days after the operation who had treated by compressing locally,transfusing blood,limiting action and using hemostyptic.1 patient with type Ⅱ diabetes mellitus had fever(T 40.5 ℃),and recovered after removing ureteral stent and using antibiotics.Conclusion MPCNL with B ultrasound guidance is a safety and effective operation for upper urinary tract calculi.更多还原