B超引导经皮肾镜气压弹道联合超声碎石术治疗开放手术后复发肾结石

Percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B-type ultrasound guidance for treatment of renal calculi after open surgery

目的:探讨B超引导经皮肾镜气压弹道联合超声碎石术治疗开放手术后复发肾结石的可行性与疗效。方法:对46例开放手术后复发肾结石患者施以经皮肾镜气压弹道联合超声碎石术治疗,其中全鹿角状结石13例,部分鹿角状结石26例,多发性结石7例。结果:46例手术均成功,平均手术时间92min;30例一期取净结石(65.2%),5例因穿刺出血仅建立经皮肾通道,12例接受二期PCNL,术后结石清率82.6%。7例术后发热,2例需要输血,1例气胸,经保守治疗均好转。结论:经皮肾镜气压弹道联合超声碎石术治疗开放手术后肾结石创伤小、并发症少、恢复快、结石清除率高,可以作为开放手术后复发肾结石的首选治疗方案。

Objective：To discuss our experience with pneumatic and ultrasonic power under B-type ultra sound guidance in treating patients with renal calculi after open operation, and to evaluate the feasibility and efficiency of this procedure. Methods： Forty-six patients with renal calculi after open surgery （13 cases with complete staghorn calculi, 26 cases with partial staghorn calculi and 7 cases with multiple renal calculi）were treated by PCNL. Results： All operations were successful, and the mean operating time was 92 minutes. Thirty cases （65.2% ）were rendered stone free after the first, Four cases was only established the percutaneous renal access because of blood loss. 12 cases had a second-look PCNL and the clearance reached 82.6%. Postoperative fever was seen in 5 cases, 2 cases required transfusion. Conclusion： Percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B-type ultrasound guidance is an effective and feasible therapeutic operation for patients with renal calculi after open operation for its advantages of less invasiveness and complications, higher clearance rate and shorter duration for hospitalization.Therefore it may be chosen as the first choice for treatment of patients with renal calculi.