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目的:探讨经皮肾镜碎石术治疗肾盏憩室结石的安全性及有效性。方法:回顾性分析11例接受经皮肾镜碎石治疗肾盏憩室结石患者的临床资料:采用标准通道经皮肾镜术4例,微通道肾镜术7例。10例行Ⅰ期直接穿刺憩室碎石术,1例因通道出血改为Ⅱ期碎石。6例术中用自制电钩切开肾盏憩室颈口。结果:手术时间平均为(1.83±0.49)h,结石直径平均为(1.73±0.71)cm,2例中盏憩室结石取净,术后未留置D-J管,1例中盏憩室结石术后完全无管化。术后复查KUB平片,9例取净,2例残留,结石直径均小于4 mm,未行碎石,结石清除率为81.8%,无并发症发生。随访3个月～1年,8例症状缓解,3例减轻。结论:经皮肾镜碎石术治疗症状性肾盏憩室结石安全可行,可做为选择性治疗方法。
Objective: To investigate the safety and efficacy of percutaneous nephrolithotripsy in the treatment of calyceal diverticula calculus. Methods: The clinical data of 11 patients who underwent percutaneous nephrolithotomy for the treatment of calyceal diverticula calculus were analyzed retrospectively: 4 cases were treated by standard-channel percutaneous nephrolithotomy and 7 cases were treated by micro-channel nephrolithotomy. 10 cases of Ⅰ direct puncture diverticula lithotripsy, 1 case of bleeding due to change to stage Ⅱ gravel. 6 cases of surgery with homemade hooks to open the neck of the calyceal diverticulum. Results: The operation time was (1.83 ± 0.49) h on average, and the average diameter of stones was (1.73 ± 0.71) cm. Two cases of midcal diverticulum stones were removed and the DJ tube was not placed after operation. Management. Postoperative KUB plain film, 9 cases of net, 2 cases of residual stones diameter less than 4 mm, no lithotripsy, stone clearance rate was 81.8%, no complications. Followed up for 3 months to 1 year, 8 patients relieved, 3 patients relieved. Conclusion: Percutaneous nephrolithotripsy for the treatment of symptomatic calyceal diverticula calculus is safe and feasible, and can be used as a selective treatment.