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目的:提高复杂性肾结石的治愈率,降低残石率,减少并发症和手术创伤。方法:回顾分析218例复杂性肾结石患者采用微创经皮肾钬激光碎石取石术(MPCNL术)治疗的临床资料。左侧复杂性肾结石96例,右侧90例,双侧32例,孤立肾或对侧肾功能丧失患者37例,合并肾功能不全氮质血症54例。结果:218例患者全部治愈。15例残余少许肾盏内小结石,未发生因并发症导致肾丢失,无死亡病例。结论:经皮肾钬激光碎石取石术具有微创、出血少、恢复快等优点。充分的术前评估及准备、娴熟的手术技巧、完善的术后处理是取得手术成功,减少术后并发症的关键。
OBJECTIVE: To improve the cure rate of complex renal calculi, reduce the residual stone rate, reduce the complications and surgical trauma. Methods: The clinical data of 218 patients with complicated renal calculus who underwent minimally invasive percutaneous nephrolithotomy and lithotripsy (MPCNL) were retrospectively analyzed. Left complex renal stones in 96 cases, right 90 cases, bilateral 32 cases, isolated kidney or contralateral renal function loss in 37 patients with renal insufficiency azotemia in 54 cases. Results: All 218 patients were cured. A small residual calyx in 15 cases of small stones, no complications resulting in kidney loss, no deaths. Conclusion: Percutaneous nephrolithothal lithotripsy has the advantages of minimally invasive, less bleeding and faster recovery. Adequate preoperative assessment and preparation, skilled surgical skills, and improve the postoperative treatment is the key to successful surgery and reduce postoperative complications.