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目的探讨多通道微创经皮肾镜取石术(MPCNL)治疗复杂性肾结石的安全性与有效性。方法经皮肾通道扩张至F14-20,用小口径的输尿管硬镜(通常为F8/F9·8)替代肾镜,采用多通道取石,利用高压灌注泵的脉冲水压,冲出小碎石。结果 23例患者中,18例患者行一期PCNL,5例肾结石合并积脓先行经皮肾穿刺造瘘术,5～7d后行二期PCNL,其中18例取净结石,其余5例术后有少许结石残留,术后结合ESWL术结石基本排出。所有患者采用2～3通道取石。9例患者术后48h内发热,其余未发现严重并发症。结论采用多通道取石可以克服单通道难以取出平行于通道的肾盏结石的缺点,提高结石清除率,减少术中出血,加快结石取出速度。
Objective To investigate the safety and efficacy of multichannel minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of complex renal calculus. Methods Percutaneous renal access was expanded to F14-20. A small diameter ureteroscope (usually F8 / F9.8) was used instead of a nephrolithotomy. Multi-channel lithotripsy was used. Using the pulse pressure of the high-pressure perfusion pump, . Results Of the 23 patients, 18 patients underwent primary PCNL and 5 patients with renal calculi combined with suppurative percutaneous nephrostomy. Secondary PCNL was performed 5 to 7 days after operation, of which 18 patients received nephrolithiasis and the remaining 5 patients After a little residual stones, ESWL combined with surgery after the basic stone discharge. All patients using 2 to 3 channel stone. Nine patients had fever within 48 hours after operation, and the remaining patients did not find serious complications. Conclusion The multi-channel stone can overcome the single channel is difficult to remove the calyx stones parallel to the shortcomings of the channel to improve stone clearance, reduce intraoperative bleeding and speed up the removal of stones.