肾上盏通道经皮肾镜取石术的安全性和疗效观察

目的：探讨。肾上盏通道经皮肾镜取石术治疗肾结石的安全性和疗效。方法：回顾性分析2008年6月～2012年5月采用肾上盏通道经皮肾镜取石术治疗的140例肾结石患者的临床及随访资料。结果：140例患者采用肾上盏通道经皮肾镜取石术治疗，平均手术时间（42±6）min；术中平均血红蛋白丢失量（8．2±2．5）g／L；一期净石率91．4％（128／140）；并发症发生率10．7％（15／140），其中术中穿刺失败、通道丢失或出血严重2例，胸膜损伤或（和）胸腔积液2例，肾盂或输尿管穿孔1例，术后出血2例，其中需要输血者1例，发热6例，尿外渗2例，无肾丢失或死亡患者；术后平均住院天数（7．5±1．2）d。结论：肾上盏通道经皮肾镜取石术治疗肾结石具有手术时间短、术中出血量少、净石率高、并发症发生率低、术后住院天数少等优点，是安全、有效的手术方法。

Safety and effect of upper kindey calyces channel of percutaneous nephrolithotomy

Objective：To investigate the safety and effect of percutaneous nephrolithotomy via upper kindey ca- lyces channel in the management of patients with renal calculi Method：Between June 2008 and May 2012, 140 ca- ses of patients with renal calculi were treated with percutaneous nephrolithotomy via upper calyce channel. Clinical data were analysed retrospectively and followed up for 3 to 36 months. Result：All 140 cases of patients with renal calculi were operated on successfully＇, the mean operating time was （42±6） minutes, blood loss was （8.2±2.5） g/L, the one--stage stone clear rate was 91.4%（128/140）, the incidence of complication was 10.7% （15/140）, failure of puncturation and loss of channel and severity blood loss were noted in 2 cases, injure of pleura 2 cases, perforation of pelvis or ureter 1 cases, blood loss after operation 2 cases, 1 cases needed blood transfusion, febrici- ty 6 cases, urinous infiltration 2 cases, neither loss of kidney nor death occurred in this group. The mean postop- erative hospital stay was （7.5±1.2） days. Conclusion：The present studydemonstrated that in the treatment of renal calculi, percutaneous nephrolithotomy via upper calyee channel was safe and effective with the advantage of shorter oper- ating time, less blood loss, high clear rate of stone, low incidence of complication, shorter hospital day.