经皮肾超声和气压弹道碎石治疗上尿路复杂性结石  

Combined ultrasound and pneumatic lithotripsy for treatment of upper urinary tract stones during percutaneous nephrolithotomy

作　　者：辛军[1] 倪建华[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,福建泉州362000

出　　处：《中国内镜杂志》2009年第12期1247-1249,共3页China Journal of Endoscopy

基　　金：福建省自然科学基金项目(No:2008J0311);泉州市优秀人才培养专项经费资助项目(No: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例患者中,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,无其他严重手术并发症。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方法。[ Objective ] To evaluate the curative effects on renal or upper uretal stones by means of combined ultrasound and pneumatic lithotripsy during pereutaneous nephrolithotomy （PCNL）. [Methods] Pereutaneous nephrostomy under uhrasonography was performed. Stones were broken into small pieces by combined ultrasound and pneumatic hthotripter （Swiss Lithoclast Master） and evacuated with suction at the mean 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 nephroscopes or ESWL, and 2 cases with residual stones were not further treated. The average time of surgery was 96 minutes and the stone clearance rate was 82.8%. No severe complication occurred during the operations. [Conclusions] Swiss Lithoclast Master appears to be a highly effective and minimally invasive device with high stone clearance rate. PCNL is believed to be an important method for the treatment of renal or upper uretal complicated stones.

关 键 词：碎石术 肾镜 尿路结石 

分 类 号：R693.4[医药卫生—泌尿科学]