B超引导经皮肾镜双导管超声碎石术治疗复杂性肾结石  

Ultrasonically guided percutanenous ultrasonic lithotripsy with cyberwand dual probe lithotriptor for complicated renal calculi

作　　者：文秀华[1] 张雪培[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《新乡医学院学报》2009年第6期578-581,共4页Journal of Xinxiang Medical University

摘　　要：目的评价B超引导下经皮肾镜Cyberwand双导管碎石系统碎石术治疗复杂性肾结石的有效性及安全性。方法对122例复杂性肾结石患者采用B超引导下经皮肾镜Cyberward双导管超声吸附碎石术治疗,并对手术时间、结石清除率及手术并发症等进行观察。结果122例均成功建立F24皮肾通道并Ⅰ期完成手术;手术时间40～150 min,平均(70.1±16.2)min;术中出血量30～150 mL,平均(70.0±9.8)mL;102例结石一次性完全取净,清石率83.6%;残留结石20例,其中泥沙样结石12例,残余小结石4例,残留输尿管内小结石3例,1例残余结石较大(直径>2 cm),需Ⅱ期手术。1例术后3 d出现肾出血,术后7 d经高选择性肾动脉栓塞介入治疗后治愈。住院时间9～15 d,平均(13.5±3.5)d;全部病例随访1～6个月,无死亡病例及感染性休克,无周围重要脏器损伤,无尿瘘及肾功能损害等严重并发症。结论B超引导经皮肾镜Cyberwand双导管超声吸附碎石治疗复杂肾结石,具有结石清除率高,手术时间短,出血少,并发症少等优点,值得临床推广。Objective To evaluate the efficiency and safety of percutaneous nephrolithotripsy on complicated renal calculi. Methods One hundred and twenty-two patients with complicated renal calculi were performed percutaneous nephrolithotripsy with cyberwand dual probe lithotriptor guided by B-type ultrasound. The operation duration, calculus clearance rate and complication were observed. Results The F24 pereutaneous renal access was successfully established in all patients. The operation duration was 40 - 150 minutes, averaged （70.1± 16.2） minutes. The blood loss was 30 - 150 mL, averaged （70.0 ± 9.8 ） mL. The stones were cleared out in 102 out of 122 cases. The calculus clearance rate was 83.6%. Other 20 eases had a residual stones, one case had a larger residual stones （ 〉 2.0 cm） needed the second stage operation. One patient accepted selectivly thrombosis of renal artery in the 7rd days after operation respectively. No severe complications such as inflammatory shock, urinary fistula or injury of abdominal organs were recorded. Conclusion Percutaneous nephrolithotomy with cyberwand dual probe lithotriptor guided by ultrasound on complicated renal calculi has the advantages of high efficiency,reliability, safety, mini invasion,less haemorrhage and rapid recovery.

关 键 词：B超引导 经皮肾镜 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]