经皮肾微造瘘大功率钬激光碎石术与气压弹道碎石术治疗复杂性肾结石的比较  

Curative Effect of Complex Renal Stone under Minimally Invasive Percutaneous Nephrostomy: Comparison Between High Power Holmiumlaser Lithotripsy and Pneumatic Lithotripsy

作　　者：丁滔[1] 李解方[1] 丁平[1] 曹友汉[1] 刘志文[1] 段有军[1] 

机构地区：[1]南华大学附属第一医院泌尿外科,湖南衡阳421001

出　　处：《海南医学》2008年第5期48-50,共3页Hainan Medical Journal

摘　　要：目的比较经皮肾微穿刺造瘘大功率钬激光碎石术与气压弹道碎石术治疗复杂性肾结石的有效性和安全性。方法回顾性分析我院自2005年1月～2007年10月使用大功率(45～60W)钬激光碎石术与气压弹道碎石术治疗复杂性肾结石患者82例92侧的临床资料,比较两种碎石方法的手术时间、结石取净率、术中出血量、并发症发生率等指标。结果钬激光组48侧患肾,气压弹道组44侧患肾,钬激光组平均碎石取石时间67min(43～124min),低于气压弹道组99min(66～142min)。钬激光组I期治疗结石排净率为75%,Ⅱ期治疗后结石总排净率为87.5%;气压弹道组I期治疗结石排净率为63.6%,Ⅱ期治疗后结石总排净率为75%。钬激光组术中出血量63ml(20～210ml),低于气压弹道组术中出血量125ml(40～310ml)。手术并发症发生率钬激光组为8.3%,低于气压弹道组18.1%。结论经皮肾微穿刺造瘘大功率钬激光碎石术治疗复杂性肾结石较气压弹道碎石术碎石时间短、效率高、手术并发症低,是治疗复杂性肾结石的有效方法。Objective To compare the efficacy and safety of minimally invasive percntaneous nephrostomy （MPCN） for complex renal stone between high power holmium laser （45-60 W） lithotripsy and pneumatic lithotripsy. Methods 82 cases （92 renal units） were analysed including the average time of lithotripsy, the rate of the stone completely expelled, intraoperative blood loss and the rate of complications treated with minimally invasive percutaneous nephrostomy between Junary 2005 to Octomber 2007. Results 48 renal units were done by minimally invasive percutaneous nephrostomy high power holmium laser lithotripsy, the average time of lithotripsy was 67 minute （43-124 minute）, the rate of the stone completely expelled was 87.5%, the average intraoperative blood loss was 63 ml （20-210 ml）, the rate of complications was 8.30%. 44 renal units were clone by minimally invasive percutaneous nephrostomy pneumatic lithotripsy, the average time of lithotripsy was 99 minute （66-142 minute）, the rate of the stone completely expelled was 75%, the average intraoperative blood loss was 125ml, the rate of complications was 18.1%. Conclusion Minimally invasive pereutaneous nephrestomy （MPCN） with high power holmium laser lithotripsy is an efficient and safe technique for complex renal stone.

关 键 词：肾结石 经皮肾微造瘘碎石术 气压弹道碎石 钬激光 

分 类 号：R692.4[医药卫生—泌尿科学]