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摘要: 目的:评价侧卧位B超引导下微创经皮肾镜取石术(mPCNL)治疗强直性脊柱炎合并肾结石的疗效及安全性。方法:强直性脊柱炎合并肾结石患者23例,男18例,女5例,平均年龄45(31~72)岁。结石位于左肾14例,右肾9例。单发5例,多发4例,部分铸型结石8例,全铸型结石6例。肾结石平均直径33(23~54) mm。均行侧卧位B超引导下mPCNL治疗。结果:23例手术患者B超引导下均穿刺成功,行微通道气压弹道碎石术。Ⅰ期结石取净19例(83%),Ⅱ期取净4例(17%)。Ⅰ期mPCNL平均手术时间72(45~136) min。术后血红蛋白下降量为18.5(16.3~20.7) g/L,术后气胸1例,未发生结肠损伤、严重出血、尿外渗及肾周感染等并发症。平均住院时间8(7~11) d。结论:侧卧位B超引导下mPCNL治疗强直性脊柱炎并发肾结石,患者能更好地耐受手术,同时便于麻醉管理,避免了X线照射,是一种值得推荐的安全、有效方法。
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