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目的:借助微创经皮肾穿刺取石术(MPCNL)建立经皮肾引导直视下进行肾乳头活检的技术,为尿结石病因的基础研究提供新的途径。方法:2005年5月～2007年10月对12例复杂肾结石行MPCNL,对术中发现已有肾乳头钙化斑形成的患者采用经皮肾引导直视下进行肾乳头活检,肾乳头活检标本送电镜观察。结果:12例患者术后无一例出现严重血尿、肾出血的并发症,无一例因严重并发症而再次手术或介入治疗,手术后随访肾功能恢复良好。结论:经皮肾腔内肾乳头活检技术安全、可行,能够在直视条件下获取肾乳头钙化斑组织进行形态学以及蛋白或基因水平的研究,为将来尿结石形成的基础研究提供了一条新的途径。
OBJECTIVE: To establish the technique of renal papilla biopsy under direct percutaneous nephrolithotomy with minimally invasive percutaneous nephrolithotomy (MPCNL), which provides a new way for the basic research on the etiology of urolithiasis. Methods: From May 2005 to October 2007, 12 patients with complicated renal calculi underwent MPCNL. Renal papilla biopsy and renal papilla biopsy were performed under direct vision of percutaneous nephrolithotomy in patients with intraoperative calcified plaque. Transmission electron microscope observation. Results: None of the 12 patients had postoperative complications of hematuria and renal hemorrhage. None of the 12 patients underwent reoperation or intervention due to serious complications. Renal function recovered well after operation. Conclusion: Percutaneous intrarenal renal papilla biopsy is safe and feasible, and it can obtain the morphology and protein or gene level of calcified plaque in renal papilla under direct vision, which provides a new basis for the basic research of urinary stone formation in the future Way.