经皮肾镜碎石联合球囊扩张术治疗症状性肾盏憩室结石  

Balloon Dilatation Combined with Minimally Invasive Percutaneous Nephrolithotripsyfor Treatment of Symptomatic Renal Caliceal Diverticular Calculi

作　　者：王滕滕[1] 张建军[1] 金讯波[1] 

机构地区：[1]山东大学附属省立医院泌尿微创中心,山东济南250014

出　　处：《泌尿外科杂志（电子版）》2014年第4期37-39,共3页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的 探讨经皮肾镜碎石联合球囊扩张术治疗症状性肾盏憩室结石的可行性及安全性。方法 2011年1月至2013年12月,采用超声引导下经皮肾镜碎石联合球囊扩张术治疗症状性肾盏憩室结石10例。术中精确穿刺肾盏憩室,扩张至16F,建立通道,应用钬激光或气压弹道碎石。而后在导丝引导下,采用球囊扩张导管扩张憩室盏颈。术后留置F14肾造瘘管至少2周。结果 10例患者均一次碎石成功,手术时间平均为60分钟(35~120分钟),术中出血量平均为50ml(20~120ml),术后住院时间平均为8.3天(7~10天)。无严重并发症。术后随访3月至半年中均未发现结石复发。结论 经皮肾镜碎石联合球囊扩张术治疗肾盏憩室结石安全、有效,其结石排净率高、并发症少、创伤小、住院时间短,可以作为症状性肾盏憩室结石的首选治疗方式。Objective To investigate the feasibility and efficacy of balloon dilatation combined with minimal-ly invasive percutaneous nephrolithotripsy (MPCNL)for symptomatic renal caliceal diverticular calculi. Meth-ods 10 patients who underwent ballon dilatation combined with MPCNL treatment of symptomatic renal caliceal diverticular calculi were retrospectively analyzed. Stones were removed with holmium laser or pneumatic litho-tripsy under the ultrasonograph guidance in all patients,and the diverticular necks were bloated with ballon dila-tation catheter and placed with a 14F nephrostomy tube for 2 weeks at least. Results All cases had a MPCNL and were rendered stone-free at one session. The average operating time was 60 minutes (35~120minutes)and the average blood loss was 50 ml (20~120ml). No severe complications occured in all patients. The hospital stay after surgery was 7~10 days. All cases had been followed up for 3~6 months in which there was no stone found in all calyceal diverticular. Conclusions Balloon dilatation combined with MPCNL is an effective and fea-sible treatment option with less invasive and high stone-free for symptomatic renal caliceal diverticular calculi. It is preferred for these selective cases.

关 键 词：球囊扩张术 经皮肾镜碎石术 钬激光 肾盏憩室结石 

分 类 号：R699.2[医药卫生—泌尿科学]