【摘要】 目的探讨彩色多普勒超声引导下微创经皮肾穿刺输尿管镜下取石术(MPCNL)治疗孤立肾肾结石的可行性和优越性。方法彩色多普勒超声引导下行MPCNL治疗孤立肾肾结石64例,其中右肾36例,左肾28例,有手术史8例。结果手术全部成功,总穿刺成功率100%,一期取石53例(82.81%),二期取石11例(17.18%),单通道取石57例,双通道7例。无腹腔内脏损伤,无明显发热,无严重出血,术侧胸腔少量积液2例(3.12%)。术后每两周超声随诊,1个月后60例(93.75%)结石完全清除,4例(6.25%)结石残留1~3粒,直径<5 mm。复查肾功能正常。结论超声引导下经皮穿刺定位准确是建立经皮肾通道的理想定位方法,结合MPCNL能有效取石,保护及改善肾功能,是治疗孤立肾肾结石的理想方法,有较大优势,对临床有很好的应用价值。更多还原

【Abstract】 Objective To investigate the feasibility and superiority of minimally invasive percutaneous nephrolithotomy(MPCNL) guided by colour Doppler ultrasound on treatmentof solitary kidney stones.Methods MPCNL guided by colour Doppler ultrasound was used to treat 64 patients with solitary kidney stones, among which 36 cases were on the right and 28 cases on the left.. Eight cases had surgery history. Results All operations were successful with a total success rate of 100%. Fifty three cases(82.81%) experienced one-stage MPCNL, and 11 cases(17.18%) experienced two sessions; 57 cases were via single channel, and 7 cases were via double channels. All cases were followed up with ultrasound per two weeks. The calculus of 60 cases(93.75%) were completely removed after 1 month, and4 cases(6.25%) had residual stones 1-3 capsules whose diameter <5 mm. Renal functions of all cases were reviewed and back to normal. Conclusions MPCNL guided by colour Doppler ultrasound was accurate, safe, less invasive,and easy to operate, and it can remove the renal stone effectively, protect and improve kidney function, so it is an ideal method treating solitary kidney stones, and it has a good clinical application value.更多还原