超声引导下经皮肾镜取石术治疗复杂性肾结石的回顾性分析:附113例报告  

Retrospective study of percutaneous nephrolithotomy under ultrasonography guidance for treatment of complex renal calculi

作　　者：曾繁飞[1] 胡成[2] 司徒杰[2] 

机构地区：[1]广东省惠州市惠州市第四人民医院泌尿外科,516005 [2]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2011年第5期28-31,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨超声引导下经皮肾镜治疗复杂性肾结石的方法、疗效,进一步提高结石清除率,降低并发症。方法回顾性分析采用超声引导经皮肾镜气压弹道超声碎石治疗113例(单侧肾结石为83例,双侧肾结石为30例)复杂性肾结石患者的临床资料,通过分析结石大小与手术时间、失血量,手术时间与失血量等数据,对手术操作方法、结石清除率、并发症等进行评价及总结。结果 113例复杂性肾结石中93例为一期取净结石,一次性清除率达82.3%。平均手术时间78±34min(45～150),失血量85±15.4ml(20～125)。术中未见严重并发症。结石大小与手术时间、失血量,手术时间与失血量之间均存在明显的线性相关关系(r=0.871,0.796,0.801,P<0.05)。结论超声引导经皮肾镜气压弹道超声碎石技术具有高效、安全等优点,在治疗复杂性肾结石方面有良好的应用价值;同时,根据结石特点设计合理的操作通道,缩短手术时间,能有效避免并发症的发生。Objective To assess the technique and clinical efficacy of percutaneous nephrolithotomy under uhrasonography guidance for treatment of complex renal calculi. Methods One hundred and thirteen cases with complex renal calculi were treated by percutaneous nephrolithomy combined with pneumatic and uhrasonic lithotripsy under the guidance of uhrasonography were analyzed retrospectively. Clinical data including operating methods,calculus elimination rate and complications were evaluated; meanwhile, correlation among calculus size, operative time and estimated blood loss were evaluated; meanwhile, correlation among calculus size, operative time and estimated blood loss were noted. Results The clearance rate of stone in stage 1 was 82.3%（93/113）, the average operative time was 78±34 min （range 45-150 min） ;the mean blood loss was 85±15.4 ml （range 20-125 ml）. Severe complications were not found during operation.Linear regression between calculus size and operative time or blood loss as well as operative time and blood loss were found significantly （P〈0.05）. Conclusion Percutaneous nephrolithomy combined with pneumatic and ultrasonic lithotripsy under the guidance of uhrasonography was an effective and safe method for treatment of complex renal calculi. Otherwise, designing appropriate operation tract according to the characteristic of stone and shortening operation time can reduce eompfieations effectively.

关 键 词：复杂性肾结石 经皮肾镜 气压弹道超声碎石 

分 类 号：R699[医药卫生—泌尿科学]