CAJ | 학술논문

目的：探讨C臂机引导下微创经皮肾输尿管镜取石术(mPCNL)治疗上尿路结石的临床疗效及安全性。方法回顾性分析2010年3月至2013年12月我院收治的200例肾结石及输尿管上段结石患者的临床资料，其中铸形及部分铸形结石58例，肾多发结石38例，双肾结石10例，单纯肾盏结石12例，单纯肾盂结石40例，肾结石合并肾积脓5例，孤立肾肾结石5例，对侧肾萎缩肾结石8例，肾结石合并肾上盏憩室结石1例，输尿管上段结石23例，结石直径0.6~4.7 cm。采用C臂机引导下微创经皮肾输尿管镜取石术进行治疗。结果所有手术均获得成功。单通道取石178例，双通道取石22例，?期取石186例，Ⅱ期取石12例，辅助ESWL 2例。手术时间30~195 min，平均(90±36) min。输尿管上段结石、肾盏结石及双侧肾结石清石率为100%，单纯肾盂结石清石率为95%，铸形结石清石率为92.8%。多发性肾结石清石率为94.7%，孤立肾肾结石清石率为80%，对侧肾萎缩肾结石清除率为87.5%，无严重并发症发生。结论采用mPCNL治疗上尿路结石具有损伤小、恢复快、疗效好、安全等优点。
목적：탐토C비궤인도하미창경피신수뇨관경취석술(mPCNL)치료상뇨로결석적림상료효급안전성。방법회고성분석2010년3월지2013년12월아원수치적200례신결석급수뇨관상단결석환자적림상자료，기중주형급부분주형결석58례，신다발결석38례，쌍신결석10례，단순신잔결석12례，단순신우결석40례，신결석합병신적농5례，고립신신결석5례，대측신위축신결석8례，신결석합병신상잔게실결석1례，수뇨관상단결석23례，결석직경0.6~4.7 cm。채용C비궤인도하미창경피신수뇨관경취석술진행치료。결과소유수술균획득성공。단통도취석178례，쌍통도취석22례，?기취석186례，Ⅱ기취석12례，보조ESWL 2례。수술시간30~195 min，평균(90±36) min。수뇨관상단결석、신잔결석급쌍측신결석청석솔위100%，단순신우결석청석솔위95%，주형결석청석솔위92.8%。다발성신결석청석솔위94.7%，고립신신결석청석솔위80%，대측신위축신결석청제솔위87.5%，무엄중병발증발생。결론채용mPCNL치료상뇨로결석구유손상소、회복쾌、료효호、안전등우점。
Objective To evaluate the clinical efficacy and safety of minimally invasive percutaneous nephrolithotomy (min-PCNL) with C-arm X-ray machine guidance in the treatment of upper urinary tract calculi. Methods The clinical data of 200 cases of renal and upper ureteral caculi treated by mPCNL from March 2010 to De-cember 2013 was analyzed retrospectively. Of all cases, staghorn calculi or partial staghorn calculi, renal multiple calcu-li, bilateral renal calculi, calyceal calculi, pelvis calculi, renal calculi accompanied by pyonephrosis, solitary renal calcu-li, with contralateral renal atrophy, renal calculi accompanied by upper calyceal diverticulum calculi and upper ureteral calculi was 58, 38, 10, 12, 40, 5, 5, 8, 1, 23, respectively. Diameter of calculi was 0.6 cm to 4.7 cm. Results All opera-tions were finished successfully. Stone removal by single-channel in 178 cases and double-channel in 22 cases respec-tively,.Among the cases,one-stage min-PCNL was performed in 186 cases, two-stage in 12 and auxiliary ESWL in 2. The operative time was 30~195 minutes, average operative time was (90±36) minutes, stone free rate in upper ureteral calculi、calyceal calculi and bilateral renal calculi was 100%, in pelvis calculi、staghorn calculi、renal multiple calculi、solitary renal calculi and with contralateral renal atrophy was 95%、92.8%、94.7%、80%and 87.5%, respectively. No serous complications occurred. Conclusion mim-PCNL is safe and effective and is a good option to treat upper uri-nary tact calculi. It has the advantages of less invasion, early recovery,better effect and higher safety.