超声引导经皮肾镜弹道超声治疗结石性脓肾

Calculous Pyonephrosis Treated by Percutaneous Nephrolithotomy with a Combination Pneumatic and Ultrasonic Lithotripsy under the Guidance of Ultrasonography

目的探讨超声引导下经皮肾镜气压弹道联合超声碎石治疗结石性脓肾的方法、疗效及其优点。方法回顾性分析2005年1月-2008年8月应用超声引导经皮肾镜气压弹道联合超声碎石治疗39例结石性脓肾患者的临床资料,对其方法、临床疗效及其优点等资料进行评价。结果39例患者行经皮肾镜气压弹道联合超声碎石,结石取净率为89.7%(35/39),2例1周后二次碎石,2例术后结合体外震波碎石(ESWL)治疗,术后随访36例患肾功能有不同程度改善,术后发生肾萎缩2例,无一例需行肾切除。结论采用经皮肾镜气压弹道联合超声碎石装置治疗结石性脓肾安全、有效、保肾率高。

Objective To investigate the techniques and effects of percutaneous nephrolithotomy with a combination pneumatic ultrasonic for calculous pyonephrosis guided by ultrasonography. Methods From Jannary 2005 to August 2008,39 cases of calculour pyonephrosis were performed by percutaneous nephrolithotomy with a combination pneumatic ultrasonic guided by ultrasonography. Clinical data including the feasibility and complication were analyzed retrospectively. Results Thirty-nine cases of calculour pyonephrosis were performed by percutaneous nephrolithotomy with a combination pneumatic ultrasonic guided by ultrasonography. Thirty-five cases achieved stone-free（89.7 %）, 2 cases operated in second stage a week later,and 2 cases with residual calculi were treated by ESWL. The renal function returned to some extent in 36 cases, Renal atrophy was observed in 2cases. No case needed nephrectomy. Conclusion Percutaneous nephrolithotomy with a combination pneumatic ultrasonic is a safe and efficient method for the treatment of calculous pyonephrosis and the rate of kidney saving is very high.