B超引导经皮肾镜气压弹道联合超声碎石术治疗上尿路结石

Percutaneous Nephrolithotomy with Pneumatic and Ultrasonic Power under B-type Ultrasound Guidance for Treatment of Calculus in Upper Urinary

目的探讨B超引导下经皮肾镜气压弹道联合超声碎石术治疗上尿路结石的安全性、可靠性及临床疗效。方法 2009年10月～2010年10月,对本组84例(92侧)患者行经皮肾镜气压弹道联合超声碎石清石系统治疗上尿路结石的临床资料进行分析,对一期治疗效果及手术并发症进行总结。结果所有患者均成功建立皮肾通道并一期碎石,平均手术时间76分,一次取净结石率94.5%(87/92),5侧有结石残留,辅助施行体外冲击波碎石或排石治疗后治愈。随访1～3个月,无严重手术并发症及后遗症。结论经B超引导下采用经皮肾镜气压弹道联合超声碎石术处理上尿路结石具有安全及疗效可靠的特点,值得临床推广应用。

Objective To evaluate the safety and clinical efficacy of combined pneumatic and ultrasound lithotripsy under ultrasound guidance during percutaneous nephrolithotripsy in treating upper urinary tract calculi. Methods From October 2009 to October 2010, the clinical data of 84 cases （92 sides）treated by percutaneous nephroscopic pneumatic and ultrasound lithotripsy system（EMS [II ） were analyzed, the curing effect and surgical complications were summarized. Result A percutaneous renal access was successfully established in all patients,the average time for whole surgery was 76 min. The stone clearance rate was 94.5 ~ （87/92）. 5 sides had a residual stone smaller than 1.0cm which were removed by extraeorporeal lithotripsy. No severe complication occurred after 1 to 3 month follow up. Conclusion The combined pneumatic and ultrasonic device appears to be efficacious and safe for disintegrating and removing large and complex renal calculi under B-type ultrasound guidance. It is worthy of clinical application.