经皮肾镜气压弹道碎石结合钬激光治疗复杂性肾结石

Treatment of complex renal stone under percutaneous nephrolithotormy with penumatic lithotripsy and holmium∶YAG laser lithotripsy

目的：探讨采用经皮肾镜气压弹道碎石结合钬激光碎石治疗复杂性肾结石的疗效。方法：回顾性分析2003年6月～2006年3月采用经皮肾碎石取石术治疗38例复杂性肾结石患者的资料。结果：一期取石29例，结石清除率76．3％（29／38）；二期取石9例，结石清除率89．5％（34／38）。平均手术时间110min，术中估计失血量平均80ml，2例术后需输血，15例术后48h内发热。无肾切除、肾盂穿孔、气胸、感染性休克等并发症发生。结论：经皮肾镜气压弹道碎石联合钬激光碎石治疗复杂性肾结石，具有创伤小、恢复快等优点，是一种安全有效的方法。

Objective：To evaluate the clinical effect of percutaneous nephro-lithotomy with penumatic lithotripsy and holmium：YAG laser lithortipsy for complex renal calculi. Methods：The information of 38 cases of complex renal stone treated with percutaneous nephrolithotomy （PCNL） between Jun, 2003 to March, 2006, were analysed retrospectively. Results：Overall 29 of the 38 patients were treated with one section , The stone-free rate was 76.3 % （29/38） and 9 cases with two sections , the stone-free rate was 89.5 % （34/38）. In 38 cases , 15 cases performed single-tract PCNL, 20 cases performed two-tract PCNL, 3 cases performed three-tract PCNL, Among them, 5 cases were performed bigger-tract （F24）PCNL. The average operation time was 110 minutes. Intraoperative blood loss was 80ml, 2 cases required blood transfution. Fever happened postoperatively in 15 cases. No obvious complications were observed. Conclusions; Percutaneous nephrolithotomy with penumatic lithotripsy and holmium： YAG laser lithotripsy for complex renal calculi has the advantages of mini-invasion,quick recovery and it is a safe and effective technigue.