微创经皮肾取石术中狭窄盏口肾盏内结石处理策略探讨.pdfVIP

第 33 卷第 10 期 安 徽 医 学 2012 年 10 月 Anhui Medical Journal 1317 微创经皮肾取石术中狭窄盏口肾盏内结石处理策略探讨 葛 亮 邓超雄 庄惠强 ［摘 要］ 目的 对微创经皮肾取石术 （MPCNL ） 中狭窄盏口肾盏内结石的处理策略进行探讨。 方法 回顾分析 2009 年 11 月至 2011 年 10 月的 99 侧例病例，对比不同方法处理狭窄盏口致并发症的发生率。 结果 采用改良方法处理狭窄盏口，MPCNL 肾盏颈口撕 裂、术野不清、术中或术后输血、盏内结石残留、被迫中止手术等发生率均有显著减少。 结论 在 MPCNL 术前、术中采取适当的措施减 少或避免肾盏撕裂的出现，不仅可以减轻患者痛苦、减少输血，而且可以提高清石成功率，应当引起 MPCNL 术者的重视。 ［关键词］ 微创经皮肾镜取石术；肾盏；肾结石 doi:10.3969/j.issn.1000-0399.2012.10.018 Treatment for calculus in stenosis kidney calices during minimally invasive percutaneous nephrolithotomy Ge Liang ， Deng Chaoxiong ， Zhuang Huiqiang Department of Urology ， the 180th Hospital of PLA ， Quanzhou 362000 ， China [Abstract] Objective To explore the treatment method for calculus in stenosis kidney calices during MPCNL. Methods All 99 cases from November 2009 to October 2011 were reviewed, and the rate of complication with different methods of treatment was compared for calculus in stenosis kidney calices during MPCNL. Results Modified method significantly reduced the rate of kidney calices tear, unclear sur－ gical field, blood transfusion during or after operation, stone remains and compulsive surgery stop. Conclusion Proper measures should been taken before and during operation of MPCNL, which would not only decreases the pain of patients and the blood transfusion amount, but also in－ creases the rate of stone clearance and surgical success. [Key words] Minimally invasive percutaneous nephrolithotomy ； Kidney calices ； Kidney calculus 自上世纪 90 年代末我国开展微创经皮肾结石取石 11 月至 2011 年 10 月，男 33 侧例，女 25 侧例；年龄 29 ~ 术 （minimally invasive percutaneous nephrolithotomy ， 60 岁，平均 42 岁。 其中，23 侧例曾行 ESWL ，6 侧例曾行 MPCNL ）并逐步改进和完善以来，其适应范围不断扩大，