标题：B超定位微创经皮肾镜取石术治疗上尿路结石229例效果观察

      作者：张鹏舒
    (桃江县人民医院泌尿外科，湖南 桃江 413400）

      卷次： 2012年23卷24期

      【摘要】 目的 探讨超声定位微创经皮肾镜取石术(mPCNL)在上尿路结石治疗中的临床疗效。方法 将
2007年1月至2010年10月我院收治的429例上尿路结石患者按治疗方法不同分为mPCNL组和PCNL组，所有
患者均随访 1年，分析术后结石清除情况及临床疗效。结果 mPCNL组 229例患者一期取净结石 194例，占
84.7%。手术平均时间（78.3±33.2）min；肾造瘘管平均留置时间(6.2±2.4) d；术后平均住院时间(6.8±2.4) d。PCNL
组200例患者一期取净结石178例，占89.0%。手术平均时间(88.8±35.5) min；肾造瘘管平均留置时间(7.8±2.8) d；
术后平均住院时间(9.6±3.5) d。两组一期取净结石率比较差异无统计学意义(P＞0.05)，但mPCNL组在造瘘时间
和住院时间上均明显少于PCNL组，两组比较差异有统计学意义(P＜0.05)。结论 超声定位行mPCNL治疗上
尿路结石具有高效、微创、安全和并发症少等优势，具有临床推广应用价值。

      【关键词】 B超定位；微创经皮肾镜取石术；经皮肾镜；上尿路结石

      【中图分类号】 R691.4 【文献标识码】 A 【文章编号】 1003—6350（2012）24—055—03<

br>Clinical effect of mPCNL with ultrasound guidance in the treatment of 229 cases of upper urinary calculi.
ZHANG Peng-shu.
Department of Urology, Taojiang People's Hospital, Taojiang 413400, Hunan, CHINA

【Abstract】 Objective To evaluate the effect of Minimally Invasive Percutaneous Nephrolithotomy
(mPCNL) with ultrasound guidance in the treatment of upper urinary calculi. Methods Four hundred and twen-
ty-nine patients with upper urinary calculi admitted from January 2007 to October 2010 were treated by mPCNL (the
mPCNL group, n=229) and mPCNL (the PCNL group, n=200). All the patients were followed up for one year. The
clinical effect and the calculi clearance rate were compared between the two groups. Results In mPCNL group, 194 of the 229
patients had calculi cleared away with one-stage, with a clearance rate of 84.7%. The mean operation duration, the remain time
of nephrostomy, and the mean length of hospital stay were (78.3±33.2) min, (6.2±2.4) d, (6.8±2.4) d, respectively. In PCNL
group, 178 of the 200 patients had calculi cleared away with one-stage, with a clearance rate of 89.0%. The mean oper-
ation duration, the remain time of nephrostomy, and the mean length of hospital stay were (88.8±35.5) min, (7.8±2.8) d,
(9.6±3.5) d, respectively. The clearance rate showed no statistically significant difference between the two groups (P>0.05). The
operation duration and the remain time of nephrostomy in the mPCNL group were significantly less than those in the PCNL
group (P<0.05). Conclusion mPCNL has the advantages of high success rate, less trauma, higher safety and reduced complica-
tions, which is worthwhile to be widely used in clinic．

      【Key words】 Ultrasound location; Minimally invasive percutaneous nephrolithotomy (mPCNL); PCNL; Up-
per urinary calculi