经皮肾镜超声联合气压弹道碎石清石术治疗复杂性肾结石

Clinical Evaluation of Combined Pneumatic and Ultrasound Lithotripsy for Complex Renal Calculi

目的评价I期经皮肾镜下超声联合气压弹道碎石清石术治疗复杂性肾结石的安全性及疗效。方法52例Ⅰ期复杂性肾结石在B超定位或C型臂X光机透视定位下,行经皮肾镜EMSⅢ代超声联合气压弹道碎石术。结果所有手术均获成功,无1例中转开放手术,术中无严重并发症。一次性手术结石清除率为78.8%（41/52）,I期肾盂梗阻解除100%。手术时间40~65 min,平均52 min。术后平均住院时间为8 d。术后随访1~3个月,结石总清除率92.3%,无严重并发症。结论经皮肾镜下超声联合气压弹道碎石清石术具有安全、高效、微创的特点,值得临床推广应用。

Objective To evaluate the safety and clinical efficacy of combined pneumatic and ultrasound lithotripsy for complex renal calculi with simultaneous percutaneous nephrolithotomy.Methods 52 cases with complex renal calculi underwent simultaneous percutaneous nephrolithotomy（PCNL） by ultrasonic power of Swiss Lithoclast Master（EMSIII.Switzerland） with positioning perspective of B-ultrasonography or C-arm X-ray machine.Results All the operations were successful with no case transferred to open operation,no case had severe complications during surgery.The curative rate was 78.8%（41/52）.The operative tine was 40~65 min,and average time consumption was 52 minutes for the operation.The average stay was 8 days after postop.No serious complications occurred during the postoperative follow-up for 1～3 months.The stone-clearance rate was 92.3%.There were no severe complication occurred.Conclusion percutaneous nephrolithotomy with EMSⅢ for complex renal calculi is recommended for the safety,high efficiency and minimal invasionin performance.