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中华腔镜泌尿外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 28 -30. doi: 10.3877/cma.j.issn.1674-3253.2018.01.008

所属专题: 文献

临床研究

微创经皮肾镜治疗多囊肾合并肾结石的疗效分析
江惠明1,(), 姚史武1, 钟凯华1, 何强1, 林毅锋1, 管得佳1   
  1. 1. 514031 广东,梅州市人民医院泌尿外一科
  • 收稿日期:2017-07-18 出版日期:2018-02-01
  • 通信作者: 江惠明

Minimally invasive percutaneous nephrolithotomy in patients with autosomal dominant polycystic kidney disease and renal stone

Huiming Jiang1,(), Shiwu Yao1, Kaihua Zhong1, Qiang He1, Yifeng Lin1, Dejia Guan1   

  1. 1. Department of Urology, Meizhou People's Hospital, Guangdong 514031, China
  • Received:2017-07-18 Published:2018-02-01
  • Corresponding author: Huiming Jiang
  • About author:
    Corresponding author: Jiang Huiming, Email:
引用本文:

江惠明, 姚史武, 钟凯华, 何强, 林毅锋, 管得佳. 微创经皮肾镜治疗多囊肾合并肾结石的疗效分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2018, 12(01): 28-30.

Huiming Jiang, Shiwu Yao, Kaihua Zhong, Qiang He, Yifeng Lin, Dejia Guan. Minimally invasive percutaneous nephrolithotomy in patients with autosomal dominant polycystic kidney disease and renal stone[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(01): 28-30.

目的

探讨超声引导下微创经皮肾镜碎石取石术(MPCNL)治疗多囊肾合并肾结石的安全性及疗效。

方法

回顾性分析梅州市人民医院自2006年1月至2015年12月采用超声引导下MPCNL治疗多囊肾合并肾结石的临床资料。

结果

共计有26例患者纳入研究,1例双侧结石,25例单侧结石,均成功建立了经皮肾通道。25例患者行一期MPCNL,1例患者行二期MPCNL,术后2~5 d复查无石率88.9%(24/27),3例残留结石患者行体外冲击波碎石术(ESWL)治疗。手术时间20~140 min,平均(68±34)min,术中失血量10~250 ml,平均(57±49)ml。术前、术后平均血肌酐为(292±51) μmol/L、(220±34) μmol/L(t=2.388,P= 0.025)。术后2例患者出现发热,4例患者接受输血治疗,无其他明显并发症。术后平均住院时间(6.8±2.4)d。随访10~24个月,结石均无复发,2例患者最终需血液透析维持治疗,其余患者肾功能稳定。

结论

MPCNL治疗多囊肾合并肾结石是安全、有效的,但多囊肾可增加手术难度及并发症。

Objective

To evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) in patients with autosomal dominant polycystic kidney disease (ADPKD) and renal stone.

Methods

The clinical data of patients with ADPKD and renal stone who underwent MPCNL in our hospital between January 2006 and December 2015 were analyzed retrospectively.

Results

twenty-seven renal units in 26 patients were included in our study. Twenty-five patients were performed in one stage MPCNL and one patient underwent second-stage MPCNL. The overall stone clearance rate was 88.9% (24/27). Three patients received ESWL because of residual calculi. The mean operation time was (68±34) min (range 20~140 min) and the mean blood loss was (57±49) ml (range 10~250 ml). The mean preoperative creatinine (Cr) and postoperative Cr level were (292±51) μmol/L and (219.8±33.6) μmol/L, (t=2.388, P=0.025). Two cases had fever postoperatively and four cases received blood transfusion because of hemorrhage.

Conclusion

MPCNL is a safe and effective approach for management of renal calculi in patients wih ADPKD.

表1 26例患者围手术期临床资料的比较(±s
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