斜卧位配合Syberwand双导管超声碎石系统行经皮肾镜碎石术187例疗效分析  

Efficacy of percutaneous nephrolithotomy with syberwand dual catheter ultrasoundlithotripsy combined with recumbent position (a report of 187 cases)

作　　者：黄喜健[1] 吴定涛[1] 闭克明[1] 陆剑君[1] 卢国平[1] 杨杰[1] 廖科诚[1] 

机构地区：[1]广西壮族自治区民族医院泌尿外科,广西南宁530001

出　　处：《现代泌尿外科杂志》2013年第6期576-577,589,共3页Journal of Modern Urology

摘　　要：目的分析斜卧位配合Syberwand双导管超声碎石系统行经皮肾镜碎石术(PCNL)治疗肾或输尿管上段结石的疗效。方法回顾性分析本院2010年1月至2012年10月的均采用斜卧位配合Syberwand碎石系统行PCNL治疗187例肾或输尿管上段结石患者。结果所有患者均成功建立F20经皮肾通道,一期平均手术时间(85.2±34.8)min,一期结石取净166例取净率88.7%,9例二期手术结石取净。11例有少量碎石残留,术后1个月行体外冲击波碎石术,残留结石全部击碎,半个月后复查基本消失。均未发生胸腹腔脏器损伤,1例因术中出血改为肾实质切开取石及止血,术后恢复良好。5例术后活动性出血,经保守治疗3例成功止血,2例行介入栓塞成功止血。术后住院时间(8.4±1.8)d。结论斜卧位配合Syberwand双导管超声碎石系统行PCNL治疗肾或输尿管上段结石安全、高效。Objective To explore the efficacy of percutaneous nephrolithotomy （PCNL） with syberwand dual catheter ul- trasound lithotripsy combined with recumbent position in the treatment of renal or upper ureteral stones. Methods A total of 187 patients with renal or the upper ureteral stones were treated in our hospital during Jan. 2010 to Oct. 2012 with PCNL with dual syberwand catheter ultrasound lithotripsy combined with recumbent position. Results F20 percutaneous nephrolithotomy channel was successfully established in all cases. The operation time averaged （85.2±34.8）min. 166 cases had stones successfully cleared,with a clearance rate of 88.7%. The stones in 9 cases were cleared in a second operation. 11 cases with residual stones were treated by extracorporeal shock wave lithotripsy after 1 month and were stone free. There was no thoracic or abdominal injury during or after operation. One case shifted to renal parenchyma lithotomy because of bleeding and recovered well. Active bleeding occurred in 5 cases,3 of whom stopped bleeding with expectant treatment,and 2 with interventional embolization. Postoperative hospital stay was （8.4±1.8）d. Conclusions It＇s safe and effective to treat renal or upper ureteral stones with PCNL with dual syberwand catheter ultrasound lithotripsy combined with recumbent position.

关 键 词：斜卧位 Syberwand双导管超声碎石系统 经皮肾镜碎石术(PCNL) 

分 类 号：R692.4[医药卫生—泌尿科学]