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目的探讨微创经皮肾镜取石术(MPCNL)治疗孤立肾肾结石的安全性及有效性。方法回顾性分析接受MPCNL治疗的孤立肾肾结石患者38例的临床资料。结果 38例患者中,并发肾积脓10例患者先行经皮肾穿刺造瘘术,5～7d后行二期MPCNL,其余28例均行一期穿刺取石,均为单通道取石,一期结石清除率86.8%。有2例残留结石移行至输尿管上段给予ESWL治疗,结石顺利排出,随访6～12个月,肾功能不全的20例患者中,13例肾功能恢复正常,其余明显好转,无重大并发症发生。结论采用MPCNL治疗孤立肾肾结石安全可行,疗效确切,具有创伤小、并发症少,恢复快、可反复操作等优点。
Objective To investigate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of solitary kidney stone. Methods The clinical data of 38 patients with solitary kidney nephrolithiasis treated with MPCNL were retrospectively analyzed. Results Among the 38 patients, 10 cases of renal pyorrhea were treated by percutaneous nephrostomy, and the second stage of MPCNL was performed after 5 ~ 7 days. The remaining 28 cases were performed with a single puncture, all of which were single-channel stone and primary stone Clearance rate of 86.8%. Two cases of residual stones migrated to the upper ureter to give ESWL treatment. The stones were discharged smoothly. Of the 20 patients who were followed up for 6 to 12 months, renal function was restored to normal in 13 of 20 patients, and the rest were markedly improved. No major complications occurred. Conclusion MPCNL is safe and feasible in the treatment of solitary kidney nephrolithiasis and has the advantages of less trauma, fewer complications, quicker recovery, and more repeated operation.