经皮肾镜超声联合气压弹道碎石术治疗肾结石(附95例报告)

Percutaneous Nephrolithotomy Combined with Pneumatic Lithotripsy for Renal Calculi:Report of 95 Cases

目的探讨经皮肾镜超声联合气压弹道碎石术治疗肾结石的疗效与安全性。方法2007年2月～2008年9月,对95例肾结石在B超引导下行经皮肾镜超声碎石术。采用EMS三代气压弹道联合超声碎石系统,单用超声或气压弹道碎石,若结石较硬则两者联合碎石。结果95例建立皮肾通道均成功。手术时间45～170min,平均85min。术中无严重并发症发生。残石17例,其中6例行二次碎石术。11例术后明显肾出血,其中9例经保守治疗成功,2例严重出血行病肾切除术。结论经皮肾镜超声联合气压弹道碎石术治疗肾结石具有高效、微创的优点。

Objective To investigate the efficacy and safety of percutaneous nephrolithotomy （PCNL） combined with pneumatic lithotripsy for renal stones. Methods Clinical data of 95 cases of renal stones that were treated by PCNL from February 2007 to September 2008 were retrospectively analyzed. The operations were done by using ultrasonography and pneumatic lithotripter system （EMS III ）. If the stones were easy to shatter, we used ultrasonic lithotripter, otherwise, pneumatic lithotripter or both of them were employed. Results The procedures were completed successfully in all of the 95 cases with the operation time ranged from 45 -170 rain （mean, 85 min）. No severe complications including pleural trauma and severe bleeding occurred during the operations. After the operation, 9 patients had fever and 11 cases showed severe hemorrhage （9 of them were cured by conservative therapy and the other 2 recovered after nephrectomy）. In the 95 patients, 17 cases had residual stones, 6 of them received a second operation. Conclusion PCNL combined with pneumatic lithotripsy is an effective and minimally invasive method for the treatment of renal stone.