微创经皮肾镜取石术治疗肾脏鹿角型结石150例研究.docVIP

微创经皮肾镜取石术治疗肾脏鹿角型结石150例研究[摘要] 目的 探讨微创经皮肾穿刺碎石(minimally invasive percutaneous nephrolithotomy,M-PCNL)治疗鹿角型肾结石的临床价值。方法回顾分析150例M-PCNL的临床资料,统计分析手术时间、术中出血量、结石清除率、住院时间及并发症发生率。结果 平均手术时间、平均出血量、术后住院时间分别为(120.6±30.0)min、(346.5±100.7)mL和(20.6±0.9)d,150 例M-PCNL中一次取净结石120 例,Ⅰ期结石取净率80%、并发症10%(15/150)。结论微创经皮肾镜取石术是治疗鹿角形肾结石的有效措施。 [关键词] 鹿角形肾结石; 微创经皮肾镜取石术 [中图分类号] R692.4 [文献标识码] A [文章编号] 1673-9701(2009)23-145-02 Clinical Analysis of Minimally Invasive Percutaneous Nephrolithotomy in Treatment of 150 Patients with Staghorn Stone of Kidney TAN Weifa1 ZENG Xiangyang2 DOU Ben1 LONG Weibing1 LIANG Zong1 1.University of South China,Hengyang Hunan 421000;2.South China University of the First People’s Hospital of Chenzhou,Chenzhou Hunan 423000,China [Abstract] ObjectiveTo analysis the clinical value of minimally invasive percutaneous nephrolithotomy(M-PCNL) in the treatment of staghorn stone of kidney. MethodsThe clinical cases were analyzed those 150 patients who underwent MPCNL. There were compared that the differences of operating time,average bleeding volume,the ratio of stone cleared,complications and postoperative time in hospital. Results The mean operation time,average bleeding volume in operation,post operative time in hospital were(120.6±30.0)min,(346.5±100.7)mL and(20.6±0.9)d. The stones were cleared completely in 120 patients(80%)treating by PCNL. the complication occurred in 15(10%)cases in MPCNL. ConclusionMinimally invasive percutaneous nephrolithotomy is the effective treatment of staghorn stone of kidney. [Key Words]Staghorn stone of kidney; Minimally invasive percutaneous nephrolithotomy(M-PCNL) 随着PCNL技术的发展、成熟与普及,经皮肾穿刺碎石术(percutaneous nephrolithotomy,PCNL)有逐渐代替传统开放手术治疗肾结石之势。2007年度,我院共行150例全鹿角型肾结石的M-PCNL。现从手术时间、出血量,结石清除率和并发症等方面进行分析,探讨M-PCNL在鹿角型肾结石治疗中的临床价值。 1 资料与方法 1.1 临床资料 150例全鹿角型肾结石患者,男80例,女70例,年龄14～55岁。B超检查发现43例,腰部疼痛41例,尿路刺激症状12例,血尿54例。腹部平片(kidney ureter bladder,KUB)+静脉肾盂造影(intravenous pyelographyh,IVP))+腹部CT平扫测量,结石长径5.0～11.0cm,右肾结石90例,左肾结