超声联合气压弹道碎石治疗上尿路结石临床研究  

Effect of Ultrasound Combined with Pneumatic Lithotripsy for Upper Urinary Tract Stones during Percutaneous Nephrolithotomy

作　　者：辛军[1] 吴文峰[1] 辛明华[1] 黄书堤[1] 蔡经爽[1] 

机构地区：[1]福建医科大学附属泉州第一医院泌尿外科,362000

出　　处：《中华全科医学》2009年第11期1150-1151,共2页Chinese Journal of General Practice

基　　金：福建省自然科学基金项目(2008J0311);泉州市优秀人才培养专项经费资助项目(07A17)

摘　　要：目的探讨经皮肾镜下超声碎石联合气压弹道碎石术(PCNL)治疗肾、输尿管上段复杂性结石的临床疗效。方法在B超引导下经皮肾穿刺造瘘,肾镜下应用组合式超声碎石和气压弹道碎石一体机将结石击碎,并同时将碎石块吸出体外。结果116例患者,96例一期取净结石,6例行二期PCNL后取净结石,12例肾盏内小块结石残留,经软性肾镜取石或体外冲击波碎石(ESWL)后治愈,2例肾盏内残留结石未进一步处理。平均手术时间96min,一期结石清除率82.8%,1例因术后活动性出血行超选择性肾动脉栓塞后止血,2例出现明显的冲洗液外渗,经引流后治愈,无其它严重手术并发症。结论肾镜下超声和气压弹道碎石术具有高效、微创和结石清除率高之优点,可作为治疗肾、输尿管上段复杂结石的重要疗法。Objective To evaluate the curative effect of ultrasound combined with pneumatic lithotripsy for renal or upper urinary tract stones during percutaneous nephrolithotomy（PCNL）. Methods Percutaneous nephrostomy under ultrasonography was performed. Stones were broken into small pieces by ultrasound and pneumatic lithotripter（ Swiss Lithoelast Master） and evacuated with suction at the same time. Results In the 116 cases, stones were cleared off at one section in 96 cases, stones were cleared off at two section in 6 cases, 12 cases with residual stones were cured by soft nephroscope or ESWL, and 2 cases with residual stones were not further treated. The average time of operation was 96 minutes and the stone clearance rate was 82.8%. No severe complication occurred during operations. Conclusion PCNL with ultrasound and pneumatic lithotripsy is a important curative method for renal or upper urinary tract stones with high efficiency, minimal invasion and high clearance rate.

关 键 词：碎石术 肾镜 尿路结石 

分 类 号：R692.4[医药卫生—泌尿科学] R693.4[医药卫生—外科学]