多发性多部位肾结石的体外冲击波碎石后加用经皮肾穿刺造瘘取石(附34例报告)

Multiplex renal calculus treated by extracorporeal shock wave lithotripsy first combined with percutaneous nepholithotomy (Report of 34 cases)

目的:探讨提高多发性多部位肾结石疗效的方法。方法:对34例多发性多部位肾结石采用ESWL治疗,对其中的未排净残石或未碎结石再联用PCNL治疗。结果:34例中,29例ESWL治疗3～6次排净结石,排净率为85.3%;4例经联用PCNLⅠ期清除残石或未碎结石,结石总排净率达97.1%。结论:经ESWL治疗后,再联用PCNL取净肾内残留结石来治疗多发性多部位肾结石,具清除率高、损伤少、安全性好、并发症少等优点,是一种经济而有效的治疗方法。

Objective：To explore the feasible way of treatment for multiple renal calculus. Methods：Review the clinical data of 34 cases who were underwent extracorporeal shock wave lithotripsy （EWSL） first and whether they were managed by percutaneous nepholithotomy （PCNL） subsequently to eliminate the residual or massive stones was based on the final effectiveness of removing calculus after EWSL. Results： Of the 34 cases, 29 cases became stone-free by 3-6 sessions of ESWL,The stone-free rate was 85.3% ; 4 patients with residual calculi were cured by one PCNL session, The overall success rate for stone-free was 97. 1%. Conclusions： Multiple renal calculus should be managed by several sessions of ESWL first and then combined with PCNL to remove the residual or massive stones according to the therapeutic effect. It is an effective treatment with high stone-free rate, less invasion, high safety, little complications and more practicality. It is highly recommended in clinical.