超声引导经皮肾镜气压弹道联合超声碎石术治疗肾结石128例  

Ultrasound-guided percutaneous nephrolithotomy combined with pneumatic and ultrasonic lithotriptic system for treatment of renal calculi: a report of 128 cases

作　　者：顾恒[1] 王昌兵[1] 袁宇峰[1] 李博[1] 叶大文[1] 

机构地区：[1]解放军第123医院泌尿外科,安徽蚌埠233015

出　　处：《蚌埠医学院学报》2013年第6期724-726,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨超声引导经皮肾镜气压弹道联合超声碎石术治疗肾结石的安全性及其疗效。方法:采用第四代EMS气压弹道联合超声碎石清石系统,在超声引导下行经皮肾镜碎石术治疗肾结石128例。结果:128例均成功建立24F标准皮肾通道,其中双通道8例,手术时间40～150 min。一期结石清除率82.0%(105/128),术中无严重并发症。23例残余结石,其中15例行二期手术,二期结石清除率86.7%(13/15)。总的结石清除率为92.2%(118/128)。8例术后大出血,其中6例经保守治疗成功,2例严重出血行肾切除术。无感染性休克和死亡。结论:超声引导经皮肾镜气压弹道联合超声碎石术是治疗肾结石安全有效的方法,值得临床推广应用。Objective：To evaluate the efficacy and safety of ultrasound guided percutaneous nephrolithotomy（PCNL） with the aid of pneumatic and ultrasonic power in treatment of renal calculi. Methods： One hundred and twenty-eight cases of renal calculi were treated by PCNL combined with pneumatic and ultrasonic lithotriptic system（ EMS 1V ） under ultrasound guidance. Results：The 24F standard percntaneous renal access was successfully established in all the cases, and two accesses were established in 8 of them. The operative time ranged from 40 to 150 minutes. The stone-free rate was 82.0% （105/128） after the first operation, and no serious complications occurred. Stones were found in 23 cases and 15 of them underwent the PCNL for the second time;the stone-free rate was 86.7% （ 13/ 15） after the second operation. The total stone-free rate was 92.2% （118/128）. Severe hemorrhage occurred in 8 eases after the operation;6 of them were cured by conservative therapy and the other 2 were performed nephrectomy. No septic shock or death occurred. Conclusions：Uhrasound-guided pereutaneous nephrolithotomy combined with pneumatic and uhrasonie lithotriptic system is safe and effective for treatment of the renal calculi. It is worth popularizing.

关 键 词：肾结石 超声引导 经皮肾镜碎石术 

分 类 号：R692.4[医药卫生—泌尿科学]