经皮肾镜下超声联合气压弹道碎石术治疗肾及输尿管上段结石的疗效分析(附1057例报告)  

Analysis of clinical efficacy of combining pneumatic and ultrasonic power in percutaneous nephrolithotomy for treatment of renal and upper ureteral calculi(Report of 1057 cases)

作　　者：徐勋[1] 胡明[1] 张湛英[1] 关礼贤[1] 冯权尧[1] 梁耿祺[1] 崔学江[1] 

机构地区：[1]南方医科大学附属南海医院泌尿外科,广东佛山528200

出　　处：《临床泌尿外科杂志》2015年第1期49-51,共3页Journal of Clinical Urology

摘　　要：目的：探讨经皮肾镜下超声联合气压弹道碎石术治疗肾及输尿管上段结石的临床疗效。方法：回顾性分析2008年7月～2013年12月我院采用经皮肾镜下气压弹道联合超声碎石术治疗肾及输尿管上段结石患者1 057例。结果：1 057例患者均Ⅰ期成功建立F24经皮肾通道,无穿刺失败及中转开放手术者,其中单通道996例,双通道53例,三通道8例。Ⅰ期碎石920例,Ⅱ期碎石137例;Ⅰ期结石清除率为89.5%（823/920）,Ⅱ期碎石后总结石清除率为91.9%（971/1057）。平均手术时间为67（30～130）min,平均碎石时间为37（5～90）min,估计术中失血量平均100（20～500）ml。随访3～36个月,均无严重并发症发生。结论：经皮肾镜下超声联合气压弹道碎石术是治疗肾及输尿管上段结石的有效方法之一,结石清除率较高,手术时间短,并发症少,可明显缩短治疗周期,降低手术费用,值得临床推广。Objective： To investigate the clinical efficacy of combining pneumatic and ultrasonic power in percu- taneous nephrolithotomy （PCNL） for treatment of renal and upper ureteral calculi. Method： Clinical data of 1 057 patients （611 males, 446 females） treated with PCNL by combining pneumatic and ultrasonic power from Jul. 2008 to Dee. 2013 were analyzed retrospectively. Result.. The percutaneous renal access was successfully estab- lished in 1057 patients. PCNL with single tract was taken in 996 patients, 53 patients received two tracts, and eight patients received three tracts. Phase I lithotripsy was performed for 920 patients, and delayed phase Ⅱ lithotripsy was performed for 137 patients. Average time required for entire procedure was 67 （range, 30-130） min, and average time for stone management was 37 （range, 5-90） min. Average estimated blood loss was 100 （range, 20-500） ml. The clearance rate of calculi in phase Ⅰ was 89.5% （823/920）, and the total one in phase Ⅱ was 91.9%（971/1057）. No severe complications were noticed during the postoperative follow-up period of 3-36 months. Conclusion： PCNL combined with nephroscopic pneumatic and ultrasound lithotripsy can obviously im- prove the efficacy of stone clearance for renal and upper ureteral calculi, and has a perfect prospect for clinical ap- plication.

关 键 词：肾结石 输尿管上段结石 经皮肾镜取石术 

分 类 号：R692.4[医药卫生—泌尿科学]