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目的:探讨超微经皮肾镜取石术(Micro-percutaneous nephrolithotomy,micro-PCNL)治疗肾结石的可行性及安全性。方法:回顾性分析2012年4～5月行micro-PCNL术的2例患者临床资料:2例患者均为下盏结石,大小分别为1.2cm和1.6cm,均有ESWL及输尿管软镜治疗失败史。采用F4.85可视穿刺针(all-seeingneedle)在X线引导下从下盏入路穿中目标盏,并直视下结合钬激光进行碎石。结果:2例患者穿刺均由下盏入路,手术时间分别为45min和55min,术后均未留置造瘘管。术后无感染、发热及出血、疼痛、尿液外渗,无输尿管石街形成等并发症。术后分别于24h、48h出院。术后4周CT复查,2例患者均无结石残留。结论:micro-PCNL治疗2cm以下肾结石安全有效,尤其可作为ESWL及输尿管软镜治疗失败后的一种补救性治疗方法。
Objective: To investigate the feasibility and safety of micro-percutaneous nephrolithotomy (micro-PCNL) in the treatment of kidney stones. Methods: The clinical data of 2 patients who underwent micro-PCNL from April to May in 2012 were analyzed retrospectively: 2 cases were lower calculus, with sizes of 1.2cm and 1.6cm respectively, both of whom failed ESWL and ureteroscopic treatment history. The F4.85 visual needle (all-seeingneedle) was used to pass the lower incandescent target under X-ray guidance. The holmium laser was combined with holmium under direct vision. Results: The puncture of the two patients was performed by the lower lamppost. The operation time was 45min and 55min, respectively, and no fistulas were retained after operation. No postoperative infection, fever and bleeding, pain, urine extravasation, ureteral stone street formation and other complications. After surgery were discharged at 24h, 48h. After 4 weeks CT review, two patients had no residual stones. Conclusion: micro-PCNL is safe and effective for the treatment of renal stones less than 2 cm, especially as a remedial treatment after ESWL and ureteroscopic soft-lens failure.