B超引导经皮肾镜双导管超声碎石术治疗肾结石与输尿管上段结石  

Ultrasonically guided percutanenous ultrasonic lithotripsy with cyberwand dual probe lithotriptor for renal and upper ureteral calculi

作　　者：王健[1] 李应忠[1] 佟发春[1] 翟成喜[1] 陈频[1] 李健[1] 靳丕东[1] 王龙[1] 

机构地区：[1]玉溪市人民医院泌尿外科,云南玉溪653100

出　　处：《云南医药》2011年第2期157-159,共3页Medicine and Pharmacy of Yunnan

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肾结石和输尿管上段结石的有效性及安全性。方法对53例肾结石和输尿管上段结石患者采用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 53例均成功建立F24皮肾通道并完成手术;手术时间40～180min,平均(78.6±18.5)min;术中出血量30～450ml,平均(80.6±9.2)ml;34例结石Ⅰ期完全取净,清石率64.1%;残留结石19例,其中15例行Ⅱ期手术,Ⅰ期和Ⅱ期手术清石率为92.4%,4例残留结石行ESWL治疗,术后自行排出,1例术后出现肾出血,经高选择性肾动脉栓塞介入治疗后治愈。住院时间7～15d,平均(12.6±3.2)d;全部病例随访1～11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肾结石、输尿管上段结石,清除率高,手术时间短。Objective To evaluate the efficiency and safety of ultrasonically guided percutanenous ultrasonic lithotripsy with cyberwand dual probe lithotriptor on renal and upper ureteral calculi.Methods 53 patients with renal and upper ureteral 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 percutaneous renal access was successfully established in all patients.The operation duration was 40～180minutes,averaged（78.6±18.5）minutes.The blood loss was 30～450 mL,averaged（80.6±9.2）mL.The stones were cleared out in 34 out of 53 cases.The calculus clearance rate was 64.1%.Other 19 cases had a residual stones,15 casehad received the second stage operation.All calculus clearance rate was 92.4%.4 patients had residual stones received treatment of ESWL.One patient accepted selectivly embolization of renal artery in the operation.The hospitalstay times was 7～15 days after operation,the average（12.6±3.2）days.All patients were followed-up for 1～3 month.No severe complications such as inflammatory shock,urinary fistula or injury of abdominal organs were recorded.Con-clusion Percutaneous nephrolithotomy with cyberw and dual probe lithotriptor guided by ultrasound on renal andupper ureteral 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 Cyberwand双导管碎石系统 肾及输尿管上段结石 

分 类 号：R692.4[医药卫生—泌尿科学]