经皮肾镜下气压弹道联合超声碎石术治疗复杂性肾结石(附42例报告)  

Clinical Efficacy of Combined Pneumatic and Ultrasound Lithotripsy under Percutaneous Nephrolithotomy for Complicated Nephrolith

作　　者：陈仙[1] 刘水清[1] 罗志刚[1] 黄江波[1] 龙炳衡[1] 秦国庆[1] 龙向阳[1] 张涛[1] 杨罗艳[2] 朱向荣[2] 

机构地区：[1]南华大学附属二医院泌尿外科,衡阳421001 [2]中南大学湘雅二医院泌尿外科,长沙410008

出　　处：《中国现代手术学杂志》2007年第2期141-143,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的评价经皮肾镜下气压弹道联合超声碎石术处理复杂性肾结石的疗效。方法回顾性分析2006年2月～2007年1月采用经皮肾镜下气压弹道联合超声碎石术治疗的复杂性肾结石42例44侧临床资料。结果42例患者均成功建立皮肾通道,采用一期单通道碎石39例,行一期两通道碎石3例。全组行一期碎石术37例,行二期碎石术5例。手术时间25～130min,平均(80±10)min,结石处理时间平均为(58±9)min,结石清除率88.1%(37/42)。5例多发性结石患者结石残留,经原通道二期碎石2例,ESWL3例,均获治愈。1例患者因术中大出血输浓缩红细胞3U。随诊1～9月,无严重手术并发症。结论经皮肾镜下气压弹道联合超声碎石术处理复杂的肾结石,具有疗效佳、安全性高、损伤小、结石清除率高的优点,值得临床推广应用。Objective To evaluate the clinical efficacy of nephrolith treated by combined pneumatic and ultrasound lithotripsy under percutaneous nephrolithotomy（PCNL）. Method From February 2006 to January 2007, 42 cases with 44 laterals of complicated nephrolith underwent combined pneumatic and ultrasonic lithotripsy under PCNL. Results All the percutaneous renal tunnel was successfully established, of which 1 tunnel was used in 39 cases and 2 tunnels were Used simultaneously in 3 cases. 37 cases underwent one stage lithotripsy and 5 cases needed a second lithotripsy later. Operation time ranged from 25 to 130 minutes, with （80 ± 10）minutes averagely. The lithotripsy time was （58 ±9） minutes. Stone were cleared in 37 out of 42 cases （88.1%）. 5 cases with residual stones were cured by second PCNL in 2 cases and adjuvant extracorporeal shock wave lithotripsy in 3 cases. 3 U of concentrated red blood cells were transfused because of hemorrhea. No complication occurred during 1 to 9 months follow-up. Conclusion The combined pneumatic and ultrasonic lithotripsy appears valid and safe for treatment of complicated renal nephrolith.

关 键 词：肾结石 肾造口术 经皮 碎石术 

分 类 号：R699[医药卫生—泌尿科学]