超声引导下侧卧位经皮肾穿刺气压弹道联合超声碎石清石术治疗复杂性肾结石

Ultrasound-guided Percutaneous Nephrolithotripsy by Pneumatic Lithotripsy Combined with Ul- trasonic Power Lithotripsy under Lateral Decubitus Position for the Treatment of Complex Nephrolith

【目的】探讨超声引导下侧卧位经皮肾穿刺气压弹道联合超声碎石清石术治疗复杂肾结石的疗效和安全性。【方法】2009年6月至2012年6月本院收治的236例复杂性肾结石患者，均在B超引导下，采用侧卧住经皮肾穿刺气压弹道联合超声碎石清石术治疗。【结果】平均手术时间（89士25）min，平均出血量（106±18）mL，平均住院时间（10．3±1．9）d，结石一次取净率79．2％，两次手术结石总取净率97．0％，无严重并发症发生。【结论】超声引导下侧卧位经皮肾穿刺气压弹道联合超声碎石清石术是治疗复杂肾结石的安全有效的方法，术中B超检查有利于结石定位穿刺、残留结石的检出和清除。

[Objective] To explore the efficacy and safety of ultrasound-guided percutaneous nephrolitho- tripsy by pneumatic litbotripsy combined with ultrasonic power lithotripsy under lateral decubitus position for the treatment of complex nephrolith. [Methods] A total of 236 patients with complex nephrolith in our hospi- tal from June 2009 to June 2012 were treated by percutaneous nephrolithotripsy by pneumatic lithotripsy com- bined with ultrasonic power lithotripsy under lateral decubitus position. [Results] The average operation time was 89±25min and the average bleeding volume was 106±18ml. The mean hospital stay was 10. 3±1.9d. The rate of one-time stone clearance rate was 79.2%, and the total two-time stone clearance rate was 97.0%. No serious complications occurred. [Conclusion] Ultrasound-guided percutaneous nephrolithotripsy by pneu- matic lithotripsy combined with ultrasonic power lithotripsy under lateral decubitus position is an effective and safe method for the treatment of complex nephrolith. B-ultrasound examination during the operation is benefi- cial for the location and puncture of stones and the detection and elimination of residual nephrolith.