Xu Ran, Yi Lu, Wang Xinyu, Zhao Hongqing, Dong Zhitao, Jiang Hongyi, Wu Hongtao, Zhao Xiaokun, Liu Ren
Department of Urology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Jun;37(6):621-4. doi: 10.3969/j.issn.1672-7347.2012.06.013.
To analyze efficacy and safety of percutaneous nephrolithotomy (PCNL) in the management of staghorn calculi with solitary kidney.
Between April 2009 and December 2011, 13 patients with renal staghorn calculi in solitary kidney were treated by PCNL in our hospital. The therapeutic effects and complications were the main points of the analysis.
Of the 13 patients, surgery time was 92-164 (117.2±21.5) min; 9 cases underwent PCNL through a single access tract, 4 cases through multi-access tracts. The stone removal rate in one session of PCNL was 76.9%, and the total clearance rate was 92.3%. Hemoglobin dropped 11-32 (16.4±4.6) g/L; one case required blood transfusion; no patient had embolism. Hospital stay was 5-10 (6.9±1.5) days postoperatively. Serum creatinine before PCNL in these patients was 83-237 (146.24±38.73) μmol/L compared to 81-242 (134.56±21.52) μmol/L by the end of the 1-month follow-up period (not statistically different). Similar findings were observed in glomerular filtration rates: before PCNL it was 42-114 (71.32±20.82) mL/min and by the end of the 1-month follow-up it was 55-117 (79.40±22.14) mL/min (not statistically different).
PCNL is effective and safe for the treatment of staghorn stones in solitary kidney, and has advantages such as short surgical duration, fewer complications, rapid recovery, short hospital stay, effective stone removal rate, and so on.
分析经皮肾镜取石术（PCNL）治疗孤立肾鹿角形结石的疗效及安全性。
2009年4月至2011年12月，我院对13例孤立肾鹿角形结石患者采用PCNL治疗。分析重点为治疗效果及并发症。
13例患者中，手术时间为92 - 164（117.2±21.5）分钟；9例经单一通道行PCNL，4例经多通道。PCNL一期结石清除率为76.9%，总清除率为92.3%。血红蛋白下降11 - 32（16.4±4.6）g/L；1例需输血；无患者发生栓塞。术后住院时间为5 - 10（6.9±1.5）天。这些患者PCNL术前血清肌酐为83 - 237（146.24±38.73）μmol/L，1个月随访结束时为81 - 242（134.56±21.52）μmol/L（无统计学差异）。肾小球滤过率也有类似结果：PCNL术前为42 - 114（71.32±20.82）mL/min，1个月随访结束时为55 - 117（79.40±22.14）mL/min（无统计学差异）。
PCNL治疗孤立肾鹿角形结石有效且安全，具有手术时间短、并发症少、恢复快、住院时间短、结石清除率高等优点。
