微创经皮肾镜碎石取石术治疗特殊肾结石的临床疗效观察

目的：研究微创经皮肾镜碎石取石术治疗特殊鹿角型或多发肾结石中的临床疗效和安全性。方法：回顾性分析2007年1月-2013年3月我院收治的37例采用微创经皮肾镜碎石取石术（PCNL）手术方式治疗的特殊鹿角形或多发肾结石患者的临床资料。结果：37例患者中，孤立肾9例、马蹄肾7例、海绵肾和多囊肾7例、儿童患者14例。成人结石直径（3．2±0．3）cm，儿童结石直径（2．2±0．2）cm。37例患者均一期单通道情况下顺利完成手术，单次手术成功率100％，结石清除率91．2％（34／37），平均手术时间（94±21．6）min，平均出血量（62±12．3）mL，术后1月复查B超提示肾脏积水减轻，肾脏功能血肌酐较术前降低，术后一月复查KUB提示3例肾脏下盏少量残留结石，4例患者出现术后低热症状。结论：采用PCNL治疗特殊鹿角形或多发肾结石的安全性好、结石清除率高、并发症较少。

The Efficacy and Safety of Percutaneous Nephrolithotomy in the Treatment of Special Types of Renal Calculi

Objective： To study the efficacy and safety of percutaneous nephrolithotomy in the treatment of special types of renal calculi（solitary kidney, horseshoe kidney, medullary sponge kidney, polycystic kidney and inpatient children） with staghorn and multiple kidney stones. Methods： The clinical data of thirty seven patients with special types of renal calculi treated by PCNL were summaried and analyzed. Results： The number of solitary kidney, horseshoe kidney, medullary sponge kidney, polycystic kidney and in patient children were 9, 7, 7 and 14 respectively. The mean diameter of stone was （3.2±0.3）cm in adults, and （2.2± 0.2）cm in children. Thirty seven patients all stabbed successfully in one time, stone free rate was 91.2%（34/37）, the average operation time was （94± 21.6）min, average intraoperative blood loss was （62± 12.3）mL, ultrasound check suggested that kidney seeper and renal function were better than those preoperative. KUB check suggested that three paitents still had small stone at subrenal calyx. Conclusion： Percutaneous nephrolithotomy （PCNL） was safe and effective in the treatment of special types of renal calculi.