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目的探讨纤维胆道肾镜在经皮肾微造瘘取石术中降低结石残留率的临床应用价值。方法在经皮肾微造瘘取石手术中共应用纤维胆道肾镜辅助治疗75例。男39例,女36例,年龄18~72岁,平均35岁;鹿角型结石13例,多发性肾结石35例,肾盂结石15例,肾盏结石4例,输尿管上段结石8例。结果全部患者出院前结石取净率92%(残留结石长径≤3mm为取净),其中Ⅰ期取净结石66/80(82.5%),Ⅱ期取净结石11/80(12.5%),2例因经济情况残留小结石出院,1例Ⅰ期取石手术后残留结石要求ESWL治疗,单通道73例,双通道2例。讨论在经皮肾微造瘘取石手术中应用纤维胆道肾镜辅助取石安全有效,明显提高结石取净率。
Objective To investigate the clinical value of fibro-biliary nephrolithotomy in reducing the residual rate of stone in percutaneous nephrostomy. Methods Percutaneous nephrostomy in 75 cases of cholecystolithiasis with adjuvant therapy. 39 males and 36 females, aged 18 to 72 years, mean 35 years old; antler type stones in 13 cases, 35 cases of multiple nephrolithiasis, pelvis in 15 cases, calyceal stones in 4 cases, upper ureteral calculi in 8 cases. Results All patients were discharged before the discharge rate of 92% of stones (residual stone long diameter ≤ 3mm to take the net), which Ⅰ to take net stones 66/80 (82.5%), Ⅱ net stones 11/80 (12.5%), Two cases were discharged due to the small economic residual stones. One case of residual stones after stage I surgery required ESWL treatment, with 73 cases of single-channel and 2 cases of dual-channel. Discussion The percutaneous nephrostomy stone surgery in the application of fibroids biliary nephrolithotomy assisted safe and effective, significantly improve the stone take rate.