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目的探讨微创经皮肾镜碎石取石术(MPCNL)治疗脊柱畸形合并肾结石的方法和疗效。方法回顾性分析广州医科大学附属第五医院泌尿外科2011年1月至2014年12月应用MPCNL治疗27例脊柱畸形合并肾结石患者的临床资料。结果一期平均手术时间(86±42,30~175)min,平均住院天数(15±7,8~32)d。平均穿刺通道大小为(19±1,14~20)F,一期结石清除率为70.4%(19/27)。8例残留结石体积为(179±161,12~440)mm2,其中7例行二期MPCNL,1例行输尿管软镜术取尽结石。输血率25.9%(7/27),2例(7.4%)行选择性肾动脉栓塞术治疗。结论 MPCNL治疗合并脊柱畸形肾结石是安全、有效的治疗手段。
Objective To investigate the method and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of spinal deformity combined with kidney stones. Methods The clinical data of 27 patients with spinal deformity and nephrolithiasis treated with MPCNL from January 2011 to December 2014 in Department of Urology, the Fifth Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Results The mean operative time (86 ± 42,30 ~ 175) min and mean length of stay (15 ± 7,8 ~ 32) d in the first phase were The average size of the puncture channel was (19 ± 1,14 ~ 20) F, the stone clearance rate was 70.4% (19/27). The volume of residual stones in the 8 cases was (179 ± 161, 12 ~ 440) mm2, of which 7 cases underwent second-stage MPCNL and one underwent ureteral soft-lensing to remove stones. Blood transfusion rate was 25.9% (7/27) and 2 cases (7.4%) were treated with selective renal artery embolization. Conclusion MPCNL treatment of spinal deformity with kidney stones is a safe and effective treatment.