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目的:探讨超声引导微创经皮肾取石术(MPNL)治疗常染色体显性遗传多囊肾疾病(ADPKD)患者合并肾结石的疗效和安全性。方法:53例被确诊为ADPKD合并上尿路结石患者,因结石体积大(直径>2 cm)在梅州市人民医院接受MPNL。记录手术的成功率、术中和术后并发症等。结果:所有的患者均穿刺成功并顺利完成MPNL,43例(75.4%)MPNL一次手术后无结石残留,13例(22.8%)由于残留结石体积较大需行二期MPNL,总的净石率89.5%。术后两周所有患者的血清肌酐有不同程度下降,差异有统计学意义(P<0.05)。结论:超声引导经皮肾取石术是一种治疗ADPKD合并的上尿路结石的安全和有效的方法,可取代X线,避免医生和患者受射线辐射损伤。
Objective: To investigate the efficacy and safety of ultrasound-guided minimally invasive percutaneous nephrolithotomy (MPNL) in the treatment of patients with autosomal dominant polycystic kidney disease (ADPKD) complicated with kidney stones. Methods: Fifty-three patients diagnosed as ADPKD complicated with upper urinary tract stones received MPNL at Meizhou People’s Hospital because of their large volume (diameter> 2 cm). Record the success rate of surgery, intraoperative and postoperative complications. Results: All the patients were successfully punctured and successfully completed MPNL. Forty-three cases (75.4%) of MPNL had no residual stones after one operation. Thirteen patients (22.8%) had MPNL due to the larger volume of residual stones. The total net- 89.5%. Serum creatinine in all patients decreased to some degree after two weeks, the difference was statistically significant (P <0.05). CONCLUSIONS: Ultrasound guided percutaneous nephrolithotomy is a safe and effective method for the treatment of upper urinary tract stones associated with ADPKD. It can replace the X-ray and prevent doctors and patients from being damaged by radiation.