CAJ | 학술논문

目的：探讨微创经皮肾穿刺取石治疗肾盏憩室结石的有效性与安全性。方法：总结本院18例采用微创经皮肾穿刺取石治疗肾盏憩室结石患者的临床资料，其中男12例，女6例，平均35.2岁。肾上盏结石10例，肾中盏结石5例，肾下盏结石3例。采用B超或X线定位引导穿刺结石所在肾盏憩室，建立通道，应用弹道碎石，同时以筋膜扩张器扩张憩室流出道，并将16 F肾造瘘管留置于肾盂内。结果：17例行一期碎石取石，余1例患者行二期微创经皮肾镜碎石取石。手术时间为（65±20）min；术中出血（75±12）mL。无术后严重并发症发生，无中转开放手术病例。结论：微创经皮肾镜碎石术创伤小，清除结石的同时可以应用筋膜扩张器扩张肾盏憩室流出道，是有症状的肾盏憩室结石患者的一种安全有效治疗手段。
목적：탐토미창경피신천자취석치료신잔게실결석적유효성여안전성。방법：총결본원18례채용미창경피신천자취석치료신잔게실결석환자적림상자료，기중남12례，녀6례，평균35.2세。신상잔결석10례，신중잔결석5례，신하잔결석3례。채용B초혹X선정위인도천자결석소재신잔게실，건립통도，응용탄도쇄석，동시이근막확장기확장게실류출도，병장16 F신조루관류치우신우내。결과：17례행일기쇄석취석，여1례환자행이기미창경피신경쇄석취석。수술시간위（65±20）min；술중출혈（75±12）mL。무술후엄중병발증발생，무중전개방수술병례。결론：미창경피신경쇄석술창상소，청제결석적동시가이응용근막확장기확장신잔게실류출도，시유증상적신잔게실결석환자적일충안전유효치료수단。
Objective:To investigate the safety and feasibility of minimally invasive percutaneoua nephrolithotripsy (MPCNL)in the treatment of caliceal diverticular calculi.Method:18 patients(12 males and 6 females,average age 35.2 years old)who had MPCNL treatment of symptomatic caliceal diverticular calculi were retrospectively analyzed.Stone-bearing caliceal were the upper calices in 10 cases and midge calices in 5 patients,and other 3 patients were in the lower calices. Stones were removed intact or fragmented with lithotripsy by MPCNL under the B type Ultrasound guidance or X-ray in all patients,and the caliceal diverticular necks were dilated with dilator and placed with a 16 F nephrostomy tube for several days.Result:17 cases had a MPCNL and were rendered stone-free at one session,only 1 case needed a second nephroscopy for the residual stone.The average operating time was(65±20)min and the average blood loss was(75±12)mL.No severe complications occurred in all patients.Nobody was transfered to open surgery during the operation.Conclusion:MPCNL may be an effective and feasible treatment option with less invasion and high stone-free rate for symptomatic caliceal diverticular calculi in selective cages.