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目的探讨超声引导微创经皮肾穿刺取石术(MPCNL)治疗复杂性肾结石的效果。方法回顾性分析采用MPCNL治疗392例复杂性肾结石患者的临床资料。145例为多发性肾结石,107例为鹿角形结石,93例为鹿角形结石伴多发性肾结石,35例为感染性结石,12例为孤立肾结石。结果手术时间35～270min,平均125min。术后26例发热,4例输血,无中转开放手术,无严重并发症。手术取净率为78.1%(307/392),43例辅以体外震波碎石(ESWL),术后2个月结石排净率为88.5%(347/392)。结论超声引导MPCNL治疗复杂性肾结石安全、有效,具有创伤小、并发症少、恢复快、结石清除率高等优点,可临床推广应用。
Objective To investigate the effect of ultrasound guided minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of complex renal calculi. Methods The clinical data of 392 patients with complicated renal calculi treated with MPCNL were retrospectively analyzed. 145 cases were multiple nephrolithiasis, 107 cases were staghorn stones, 93 cases were staghorn stones with multiple nephrolithiasis, 35 cases were infectious stones and 12 cases were isolated kidney stones. Results The operation time was 35 ~ 270min with an average of 125min. 26 cases after fever, 4 cases of blood transfusion, no transfer of open surgery, no serious complications. The surgical removal rate was 78.1% (307/392), while 43 cases were treated with extracorporeal shock wave lithotripsy (ESWL). The stone clearance rate was 88.5% (347/392) at 2 months after operation. Conclusion Ultrasound-guided MPCNL is safe and effective in the treatment of complicated renal calculi. It has the advantages of less trauma, less complications, quick recovery and high stone removal rate. It can be widely used clinically.