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目的:探讨微创经皮肾穿刺输尿管镜碎石取石术(mini PCNL)治疗复杂性上尿路结石(肾结石及输尿管上段结石)的疗效及安全性。方法:对106例接受mini PCNL治疗的复杂性上尿路结石患者的临床资料进行回顾性分析。结果:106例患者中,103例成功施行一期取石术,3例中转开放手术;一期取净结石66例,二期取净结石20例,三期取净结石7例,结石总取净率87.74%;平均手术时间130min,肾造瘘管留置时间平均5d,平均住院9d,其中2例需要输血,其余101例估计术中出血量25～190ml,平均70ml;其余未出现严重的并发症。结论:mini PCNL具有损伤小、恢复快、住院时间短、结石清除率高、并发症少等优点,是治疗复杂性上尿路结石的较好的微创方法。
Objective: To investigate the efficacy and safety of minimally invasive percutaneous nephrolithotomy (mini PCNL) in the treatment of complicated upper urinary tract calculi (nephrolithiasis and upper ureteral calculi). Methods: The clinical data of 106 patients with complicated upper urinary tract stones treated with mini PCNL were retrospectively analyzed. Results: Of the 106 patients, 103 were successfully treated with stage I and 3 with open surgery. The first stage was 66 cases of net stones, the second stage of net stones were 20 cases, the third stage of net stones were 7 cases, The average operation time was 130 min. The average time of renal fistula indwelling was 5 days and the average hospitalization was 9 days. Two cases needed blood transfusion. The remaining 101 cases estimated the intraoperative blood loss from 25 ml to 190 ml with an average of 70 ml. Other serious complications did not occur. Conclusions: mini PCNL has the advantages of less injury, faster recovery, shorter hospitalization time, higher rate of stone removal and fewer complications. It is a better minimally invasive method for the treatment of complex upper urinary tract calculi.