经皮肾镜下气压弹道碎石联合超声碎石术治疗复杂性肾结石疗效观察

Clinical efficacy of a combined pneumatic and ultrasound lithotripsyduring percutaneous nephrolithotomy

目的 :评价经皮肾镜下气压弹道碎石联合超声碎石术处理复杂性肾结石的疗效。方法 :自 2 0 0 3年9月～ 2 0 0 4年 4月采用经皮肾镜下气压弹道碎石联合超声碎石术I期治疗肾结石 38例 4 2侧。结果 :平均手术时间 85min ,结石处理时间 6 2min ,结石清除率 88.1% ;5例多发性结石或铸形结石患者经皮通道小角度的肾盏内有直径小于 1cm结石残留 ,辅助施行体外冲击波碎石治疗。随访 1～ 3个月 ,无严重手术并发症。结论 :经皮肾镜下气压弹道碎石联合超声碎石术处理大的复杂性肾结石具有高效、安全的特点 ,结石清除率高 ,值得临床推广应用。

Objective:To investigate the clinical efficacy of combined contact pneumatic and ultrasound lithotripsy during percutaneous nephrolithotomy.Method:From Sep 2003 to Apr 2004, 42 renal units in 38 patients underwent percutaneous nephrolithotomy using a combined pneumatic and ultrasonic lithotrite.Clinical data was analyzed retrospectively.Results:The average time for whole surgery was 85 min and the time for complete stone clearance was 62 min. The stone clearance rate was 88.1 % and 5 cases had a residual stone smaller than 1.0 cm due to an inaccessible location. No complication occurred during nephrolithotomy after 1 to 3 month fellow up.Conclusion:The combined pneumatic and ultrasonic device appears to be efficacious and safe for disintegrating and removing large and complex renal calculi.