微创经皮肾镜气压弹道碎石临床应用.docVIP

微创经皮肾镜气压弹道碎石临床应用作者单位：161000 齐齐哈尔医学院附属第三医院 通讯作者：辜振刚 【摘要】 目的 探讨与评价微创经皮肾镜气压弹道碎石（MPCNL）治疗肾与输尿管上段结石的方法与疗效。方法 回顾性分析2006年10月～2009年10月采用MPCNL治疗的198例肾结石患者的临床资料。结果 198例患者均成功建立皮肤肾脏通道，其中1 次取净结石149例，2次取净45例，3次取净4例。结石总取净率为75.7%，手术时间平均为55 min，术中出血量50～150 ml,平均70 ml, 1次取净结石患者住院时间平均7 d，随访1～12个月，无严重手术并发症发生。结论 微创经皮肾镜气压弹道碎石术治疗上尿路结石具有微创损伤、恢复快、并发症少、安全高效、结石清除率高的优点。 【关键词】 上尿路结石; 微创手术; 经皮肾镜 Minimally invasive percutaneous nephrolitithotomy in treatment of upper urinary lithiasis GU Zhen-gang,ZHAO Ming.The Third Affiliated Hosptial of Qiqihar Medical College, Qiqihar 161000,China 【Abstract】 Objective To investigate and access the clinlal technique and efficacy of minimally invasive percutaneous nephrolithotomy combined contact pneumatic lithoripsy for upperurinary lithiasis treatment.Methods From October 2006 to October 2009，the clinicd date of 198 cases of kidney stones under PCNL.Results All thepercutaneous renal tunnel was successfully established.149cases presented stone free on the first MPCNL,45 cases presented stone free on the second MPCNL, 4 cases presented stone free on the third MPCNL.The mean operation time of the miniper cutaneous nephrolithotomy was 55minutes,the one time clearcace 75.7%.The intraoperative blood loss was 50-150 ml,mean 70 ml,the length of postoperative hospital stay was seven days,no serious surgery concerned complication occurred during nephrolithotomy after 1 to 12 month fellow up.Conclusion The minimally invasive percutaneous nephrolithotomy combined pneumatic device appears to be minimally invasive, quick recovery,less complication,efficacious, safe and high stone-free rate for upper urinary calculi remove. 【Key words】 Upper urinary calculi; Minimally invasive surgery; Perrontaneous nephrolithotomy 经皮肾镜下气压弹道碎石术是目前治疗复杂性肾结石的有效手段，也是治疗输尿管上段结石的重要方法。如何完善经皮肾镜碎石的手术操作方法、提高其安全性，是临床一直关注的问题。笔者所在医院2006年lO月～2009年11月共治疗复杂性肾结石患者198例，现回顾性分析如下。 1 资料与方法 1.1 一般资料 选择笔者所在医院复杂性上尿路结石患者198例为研究对象，男112例，女86例；年龄28～65岁，平均40岁。单发肾结石47例，多发结石83例，肾铸形结石36例，单纯输尿管上段结