微创经皮肾气压弹道联合钬激光碎石治疗复杂性肾结石

The treatment of complicated renal calculus with percutaneous nephrolithotomy and holmium laser lithotripsy

目的探讨微创经皮肾气压弹道联合钬激光碎石治疗复杂性肾结石的临床疗效。方法采用X线或B超定位引导经皮肾穿刺建立F18通道,使用德国WOLF李氏肾镜,应用国产APL气压弹道碎石机联合科瑞达钬激光治疗复杂性肾结石86例。结果全组无中转手术及严重并发症,手术时间1.5～4.0h,平均2.0h,输血2例。术后4周结石排净率为74.4%(64/86)。结论微创经皮肾气压弹道联合钬激光碎石治疗复杂性结石碎石效率高、创伤小、恢复快、并发症少,术后配合ESWL及中药排石可进一步提高肾结石的清除率,值得临床推广应用。

Objective Analyze the clinical efficacy of percutaneous nephrolithotomy and holmium laser lithotripsy on complicated renal calculus.Methods 86 patients with renal calculi using X-ray or ultrasound-guided percutaneous renal positioning puncture establish F18 channel,German WOLF Lee renal mirror,APL Pneumatic lithotripsy Machine(domestic)and holmium laser lithotripsy.Results Among the patients,no one had interim surgery or serious complications,the average operation time was 2.0 hours which range from 1.5 to 4.0 hours,and two cases had blood transfusion.The rate of stone discharge after four weeks was 74.4%(64/86).Conclusion The method of treat complicated renal calculus with percutaneous nephrolithotomy and holmium laser lithotripsy had high efficiency,less trauma,quicker recovery and fewer complications,and the clearance rate of kidney stones can be further enhanced if ESWL and Chinese Paishi can be used after operation,it was worthy of clinical application.