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目的:探讨超声引导下行多通道经皮肾镜术治疗肾鹿角形结石的可行性及手术经验。方法:2004～2008年行超声引导下多通道PCNL治疗鹿角形肾结石163例,对其临床资料进行了回顾性分析。其中,男130例,女33例。完全性鹿角结石105例,部分性鹿角结石58例。将患者分为二组,分期建立多通道者131例为第一组,一期建立多通道者32例为第二组。结果:术中、术后未发生严重并发症。第一组结石取净107例,结石取净率81.7%;总手术时间130～240 min,平均146 min;住院14～23天,平均17天;术后输血者8例(6.1%)。第二组结石取净28例,结石取净率87.5%;总手术时间90～160 min,平均115 min;住院7～15天,平均10天;术后输血者3例(9.4%)。第二组的总手术时间、住院天数显著少于分期建立多通道者,但输血率和结石清除率无显著差别。结论:超声引导下多通道经皮肾镜术治疗肾鹿角形结石安全、可靠。一期建立多通道比分期建立多通道随着经验的积累,更值得采用。
Objective: To investigate the feasibility and operation experience of ultrasound-guided multi-channel percutaneous nephrolithotomy in the treatment of renal antler’s calculi. Methods: From 2004 to 2008, 163 cases of deer horn - shaped kidney stones were treated with multi - channel PCNL guided by ultrasound. The clinical data of them were retrospectively analyzed. Among them, 130 males and 33 females. Complete antler stone in 105 cases, partial antler stones in 58 cases. The patients were divided into two groups, 131 cases of multi-channel establishment were divided into the first group, 32 cases of multi-channel establishment of the first group as the second group. Results: No intraoperative and postoperative complications occurred. The first group of stones were taken from the net in 107 cases, the stone removal rate was 81.7%. The total operation time was 130-240 minutes (mean 146 minutes). The patients were hospitalized for 14-23 days with an average of 17 days. Eight patients (6.1%) were transfused after operation. The second group of stones were removed in 28 cases, the stone removal rate was 87.5%. The total operation time was 90 to 160 minutes (mean, 115 minutes). The patients were hospitalized for 7 to 15 days with an average of 10 days and 3 cases (9.4%) of postoperative blood transfusions. The total operation time and hospitalization days in the second group were significantly less than those in the multi-channel stage, but there was no significant difference in the rates of blood transfusion and stone clearance. Conclusion: Ultrasound-guided multichannel percutaneous nephrolithotomy is safe and reliable for the treatment of renal antlers. A multi-channel stage than the establishment of multi-channel than the accumulation of experience, more worthy of adoption.