CAJ | 학술논문

目的总结单一微通道经皮肾镜碎石术(MPCNL)联合输尿管软镜碎石术治疗鹿角形肾结石的临床经验体会.方法 57例鹿角形肾结石均采用MPCNL和输尿管软镜碎石术联合治疗.结石大小(2.7 cm×3.3 cm～3.8 cm ×5.2 cm),平均3.7 cm ×4.1 cm.结果 46例鹿角形结石一期碎石、取石成功,平均手术时间128 min,平均出血量80 mL(20～150 mL),结石清除率为80.7%;11例残余结石主要集中于肾下盏,少部分位于肾中盏,于术后1个月行二期输尿管软镜碎石术,平均手术时间为57 min,结石总清除率为93%(53/57).4例术后仍有少量结石残留,大小为0.4～0.8 cm,予以体外冲击波碎石术(ESWL)治疗,随访3个月,结石清除2例.结论 MPCNL联合输尿管软镜碎石术治疗鹿角形肾结石可有效提高结石清除率,减少创伤及并发症.
목적 총결단일미통도경피신경쇄석술(MPCNL)연합수뇨관연경쇄석술치료록각형신결석적림상경험체회.방법 57례록각형신결석균채용MPCNL화수뇨관연경쇄석술연합치료.결석대소(2.7 cm×3.3 cm～3.8 cm ×5.2 cm),평균3.7 cm ×4.1 cm.결과 46례록각형결석일기쇄석、취석성공,평균수술시간128 min,평균출혈량80 mL(20～150 mL),결석청제솔위80.7%;11례잔여결석주요집중우신하잔,소부분위우신중잔,우술후1개월행이기수뇨관연경쇄석술,평균수술시간위57 min,결석총청제솔위93%(53/57).4례술후잉유소량결석잔류,대소위0.4～0.8 cm,여이체외충격파쇄석술(ESWL)치료,수방3개월,결석청제2례.결론 MPCNL연합수뇨관연경쇄석술치료록각형신결석가유효제고결석청제솔,감소창상급병발증.
Objective To summarize the clinical experience of combined single-access minimally invasive percutaneous nephrolithotomy (MPCNL) and lithotripsy through flexible ureteroscope in the treatment of staghorn calculi.Methods Fifty-seven cases of renal staghom calculi underwent combined MPCNL and lithotripsy through flexible ureteroscope.The size of calculi was (2.7 cm×3.3 cm-3.8 cm × 5.2 cm),3.7 cm×4.1 cmon average.Results The success rate of stone fragmentation was 80.7% (46/57) after the first stage of operation,duration of which was 128 min on average.The average loss of blood was 80 mL (20 - 150 mL).Eleven patients with residual calculi in the middle and lower calyx were also underwent the second stage of operation after 5 - 7 days.The average operation duration of the second stage was 57 min and the total clearance rate was 93% (53/57).Four cases had a few of residual calculi with size of 0.4 - 0.8 cm and went on with the treatment of extracorporeal shock wave lithotripsy(ESWL).Two cases were stone-free in the follow-up for 3 months.Conclusion MPCNL combined with with lithotripsy through flexible ureteroscope on the treatment of staghom calculi can decrease the therapeutic risk and complication,increase the rate of stone-free and safety.