肾盂切开配合气压弹道碎石治疗巨大肾结石体会

Pyelolithotomy with pneumatic lithotripsy in treating large renal calculi

目的探讨肾盂切开配合气压弹道碎石治疗巨大肾结石的临床疗效。方法总结分析在肾盂切开取石术中配合气压弹道碎石技术治疗46例巨大肾盂及肾铸型结石患者的临床资料。结果46例患者均取石成功,平均手术时间136min,术中平均出血量约120mL,术后1周复查B超和KUB,结石1次取尽者41例(41/46);5例(5/46)结石残留,直径约0.5～0.8cm,结合体外碎石,1个月后复查B超和KUB,结石排尽。结论肾盂切开配合气压弹道碎石治疗巨大肾结石,可避免行广泛肾实质切开,可更好地保护肾功能及减少术中出血量,降低复杂肾结石的手术难度和残石率。

[ Objective] To investigate the curative effect of pyelolithotomy with pneumatic lithotripsy in treating large renal calculi. [Methods] The data of 46 cases with large pelvic calculi, who underwent pyelolithotomy with pneumatic lithotripsy, were summarized and analyzed. [ Results ] Operations for all the 46 cases were successful, the average operation time was 136 minutes and the average blood loss during operation was about 120 mL. Forty-one cases were found stone-free in reexamination of B ultrasonography and KUB one week after operation （41/46）; five eases （5/46） had residual stones, the diameter of which was about 0.5-0.8 cm; treated with extraeorporal lithotripsy, they were found stone-free in reexamination of B ultrasonography and KUB one month after. [ Conclusion] Pyelolithotomy with pneumatic lithotripsy in treating large renal calculi can avoid cutting the kidney parenchyma, protect kidney function and decrease hemorrhage, reduce the difficulty and risk of complicated renal calculi opera- tion. This technique is valuable for the hospitals which have the equipment for pneumatic lithotripsy.