经皮肾镜超声碎石术治疗上尿路结石  

Treatment of upper urinary tract stones by ultrasound guided lithotripsy in percutaneous nephrolithotomy (report of 120 cases)

作　　者：韩杰[1] 黄群联[1] 程庆水[1] 姜书传[1] 董昌斌[1] 卓栋[1] 

机构地区：[1]皖南医学院附属弋矶山医院泌尿外科,安徽芜湖241001

出　　处：《中华腔镜泌尿外科杂志（电子版）》2009年第2期13-15,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的回顾性分析经皮肾镜超声碎石术治疗上尿路结石的疗效及安全性。方法对120例上尿路结石患者在超声定位引导下行经皮肾镜超声碎石术。俯卧位经皮肾通道建立成功后,采用EMS三代气压弹道联合超声碎石系统,单用超声或气压弹道碎石,若结石较硬则两者联合碎石。结果120例手术均获成功。手术时间45～170min,平均85min,单通道118例,双通道2例,一期完成碎石113例,二期手术7例。术中无严重并发症发生。12例术后严重肾出血,9例经保守治疗成功,1例行选择性肾动脉栓塞成功,2例严重出血行病肾切除。结论经皮肾镜超声碎石术治疗肾结石具有高效、微创的优点。Objective To study the efficacy and safety of ultrasound guided lithotripsy in percutaneous nephrolithotripsy （PCNL） for upper urinary tract stones. Methods Clinical data of 120 renal stones cases who underwent ultrasound guided PCNL from February 2007 to December 2008 were retrospectively analyzed. The operations were done by using ultrasonic and pneumatic lithotripter system （EMS Ⅲ）. If the stones were easy to shatter, we used ultrasonic lithotripter, pneumatic lithotripter or both of them when the stones were hard. Results All 120 cases operation procedure were successful, the operative time was 45-170 min, the average time was 85min. No severe complications were observed during the operations. 12 cases had severe hemorrhage postoperation, 9 cases with successful conservative therapy, one was succesfully treated by hyperselective embolization while 2 cases with nephrectomy. Concluaions Treatment of renal stones by ultrasound guided PCNL is an effective and minimally invasive approach.

关 键 词：肾结石 经皮肾镜 碎石 

分 类 号：R699[医药卫生—泌尿科学]