摘要
目的评价超声引导经皮肾镜气压弹道联合超声碎石术处理复杂性上尿路结石的疗效。方法 2009年1月至2009年8月采用超声引导经皮肾镜气压弹道联合超声碎石术治疗复杂性上尿路结石51例56侧。结果全部病例均一期手术成功,50侧行单通道取石,4侧行双通道取石,2侧行多通道取石,平均手术时间85min,一次取净结石率87.5%(49/56),7侧行二次手术清除残余结石,二次术后残余结石直径均小于1.0cm,辅助施行体外冲击波碎石或排石治疗。随访1～3个月,无严重手术并发症。结论超声引导经皮肾镜具有定位准确,工作通道建立方法安全简便的特点。气压弹道碎石联合超声碎石术处理复杂上尿路结石具有碎石高效安全、结石清除率高、创伤小、恢复快、并发症少等特点。
Objective To investigate the clinical efficacy of combined contact pneumatic and ultrasound lithotripsy during percutaneous nephrolithotomy under ultrasound guidance for the treatment of complex upper urinary calculi.Methods From January 2009 to August 2009,56 renal units in 51 patients underwent percutaneous nephrolithotomy using a combined pneumatic and ultra-sonic lithotrite via ultrasound guidance for treatment of complex upper urinary tract calculi.Clinical data was analyzed retrospectively.Results All the cases was cured successfully in one stage.Fifty renal units were cured by one tunnel way,4 renal units by double tunnel,and 2 renal units by multiple tunnels.The average time for whole surgery was 85 min.The calculi degradation rate was 100% and the calculi clearance rate was 87.5%（49/56）while 7 cases had a residual calculi smaller than 1.0 cm in diameter due to an inaccessible location.These 7 cases were cured by ESWL or drug treatment.No complication occurred during 1 to 3 months＇follow-up.Conclusions The value of PCNL under ultrasound guidance for the treatment of complex upper urinary tract calculi is accurate locat-ing,the construction of tunnel is safe and convenient.A combined pneumatic and ultrasound lithotripsy device deal with complex upper urinary tract calculi during percutaneous nephrolithotomy appears to be efficacious and safe for calculi clearance with less compli-cations.
出处
《中华腔镜泌尿外科杂志（电子版）》
2010年第3期8-10,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
复杂上尿路结石
经皮肾镜取石术
碎石术
Complex upper urinary tract calculi Percutaneous nephrolithotomy Lithotripsy
