【摘要】 目的探讨微创经皮肾镜钬激光碎石术(minimally invasive percutaneous nephrolithotomy,MPCNL)治疗上尿路结石的方法和疗效。方法回顾性分析2010年8月~2012年12月采用C臂X光机定位或B超引导下穿刺,扩张建立经皮肾通道,在输尿管镜下采用钬激光碎石系统治疗肾、上段输尿管结石185例。结果本组患者185例均Ⅰ期穿刺取石成功,48例复杂性肾结石采用单通道取石25例,双通道取石23例;Ⅰ期取石172例,Ⅱ期取石13例;平均定位时间8(1~25)min,平均建立通道时间15(5~30)min。无中转开放手术。术后复查KUB、超声,结石排净率92%,未出现严重出血、液气胸、腹腔脏器损伤等并发症。结论微通道经皮肾镜钬激光碎石术治疗上尿路结石疗效确切,损伤小,恢复快,并发症少,值得临床推广应用。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy( MPCNL) with holmium laser lithotripsy in treating upper urinary tract calculi. Method It was retrospectively studied in 158 patients who performed MPCNL for treating upper urinary tract calculi.Results There were 172 cases successful undergone one-stage MPCNL,and 13 cases needed two-stage MPCNL. In 48 cases of complex renal calculi,the single channel MPCNL was used in 25 cases,and double channel MPCNL was used in 23 cases. The average location time was 8( 1 ~ 25) minutes,and average tunnel-construction time was 15( 5 ~ 30) minutes. No case suffered from the puncture failure,or conversion to open operation. Postoperative examination by KUB and ultrasonography showed that the stone clearance rate was 92%. No patient had massive hemorrhage,hydropneumothorax or injuries to the abdominal organs. Conclusions The minimally invasive percutaneous nephrolithotomy combined holmium laser appears to be minimal invasion,quick recovery,less complication,higher effectivity,more safety and higher stone-free rate for upper urinary calculi removal.更多还原