经皮肾镜超声碎石清石联合自制钩状电极一期治疗肾盏憩室结石  

Percutaneous ultrasonic nephrolithotomy combined with homemade hook electrode for treatment of renal caliceal diverticular calculi

作　　者：王强[1] 孙家庆[1] 晁亮[1] 曹成松[1] 孙光耀[1] 吴永第[1] 王军起[1] 

机构地区：[1]徐州医学院附属第三医院泌尿外科,江苏徐州221003

出　　处：《中华腔镜泌尿外科杂志（电子版）》2013年第1期31-33,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨经皮肾镜超声碎石清石联合自制钩状电极一期治疗肾盏憩室结石的临床应用价值。方法回顾性分析我院采用经皮肾镜超声碎石清石联合自制钩状电极一期治疗14例肾盏憩室结石的病例资料。其中女性8例，男性6例；平均年龄36.4岁。14例均为肾脏背外侧的肾盏憩室结石，其中上盏憩室结石6例，中盏憩室结石4例，下盏憩室结石2例，肾盂结石合并肾盏憩室结石2例。采用超声引导下直接穿刺结石所在的肾脏背外侧肾盏憩室，应用瑞士第三代超声碎石清石系统操作，同时在美蓝引导下以自制电凝钩切开狭窄的憩室颈部。结果13例手术成功，未出现大出血或邻近器官损伤等并发症，术后复查无结石残留，双J管位置良好。手术时间30—120min，平均68±25min，术中出血量为50～200ml，平均出血量80ml。术后平均住院时间7d，肾造瘘管留置时间4周。1例患者。肾盏憩室开口位于视野盲区未能行憩室颈部切开术，予无水酒精灌注处理。结论经皮肾镜超声碎石清石联合自制钩状电极一期治疗肾盏憩室结石技术可行、安全、疗效确切。Objective To explore the clinical value of percutaneous ultrasonic nephrolithotripsy and self-made hook-like electrode in the treatment of renal calceal diverticular calculi. Methods The data of 14 cases in our hospital of renal calceal diverticular calculi treated by percutaneous ultrasonic nephrolithotripsy and hook-like electrode, of that 8 were female and 6 were male with an average age of 36.4 years old were analyzed. These 14 cases had all kidney dorsolateral calceal diverticular calculi, of which 6 were upper diverticular cases, 4 were medium diverticular cases, 2 were lower diverticular and 2 were renal pelvic calculi merging calceal diverticular calculi. B ultrasound guidance was used in penetrating directly into the corresponding diverticulum, with the application of the third generation Swiss ultrasonic lithotripsy clearance system and the guidance of the Methylene Blue, nephrodithotomy were performed and it turns out to be that the neck of the diverticulum were cut with the help of hook cautery incision. Results Thirteen cases were successful with no massive hemorrhage, adjacent organ damaged or other complications. No residual calculi was observed after the operation and the double J stents was in good position. The whole duration of the operation was 30-120 minutes with an average of 69_＋25 minutes, and the blood loss was 50 to 200 ml and 80 ml in average. The average hospital stay was 7 days and the time of nephrostomy tube indwelling is 4 weeks. One procedure was failed due to the diverticular neck and was treated by anhydrous alcohol infusion. Conclusions The use of percutaneous ultrasonic nephrolithotripsy and homemade hook-like electrode in the treatment of renal calceal diverticular calculi is feasible, safe and efficient.

关 键 词：经皮肾镜取石术 超声碎石 肾盏憩室 钩状电极 结石 

分 类 号：R692.4[医药卫生—泌尿科学]