单通道微造瘘经皮肾镜吸引清石系统结合超声定位治疗上尿路结石中的价值

Value of stone-breaking and suction system combined with ultrasonography in treating upper urinary calculi by using minimally invasive percutaneous nephrolithotomy in single channel

目的探讨单通道微造瘘经皮肾镜吸引清石系统结合超声定位治疗上尿路结石中的价值。方法回顾性分析2011年12月～2013年8月212例采用单通道微造瘘经皮肾镜吸引清石系统结合超声定位治疗的上尿路结石患者资料，记录碎石取石时间、出血量、结石取净率、手术并发症。结果本组212例患者均成功建立通道，207例一期手术，5例合并集合系统积脓二期手术，治疗成功209例，成功率为98．6％。结石取净率96．2％（204／212），解除积水100％，碎石取石时间平均45．2min，出血量平均267ml，无周围脏器损伤及死亡病例。8例残留结石均〈0．6em。术后输血6例（2．8％），介入治疗1例（0．5％），术后发热19例（9．0％）。196例术后随访3～6个月，平均4个月，未见结石复发。结论单通道微造瘘经皮肾镜吸引清石系统结合超声定位治疗上尿路结石成功率高、方便、安全，是一种微创高效的方法，具有重要的临床应用价值。

Objective To investigate the value of stone-breaking and suction system combined with ultra- sonography in treating upper urinary calculi by using minimally invasive percutaneous nephrolithotomy in single channel. Methods From 2011 December to 2013 August, we retrospective reviewour outcome when using sin- gle channel minimally invasive percutaneous nephrolithotomy to treat upper urinary calculi in 212 patients with the aid of a stone-breaking and suction system combined with ultrasonography,we record the rubble stone time l amount of bleeding, the stone clearance rate, operation complications. Results In this group, 212 patients were successfully established channels, 207 cases with one stage operation, 5 cases complicated with empyema eollectionsystem two stage operation, treatment was successful in 209 cases, the success rate is 98. 6%. The stone clearance rate was 96. 2% （204/212）, releasing water 100% stones, the time average 45.2 min, the av- erage amount of bleeding 267 ml, no damage to surrounding organsand death cases.8 cases of residual stones were ＇0. 6cm. 6 cases ofpostoperative blood transfusion （2. 8% ）, 1 cases of interventional therapy （0. 5% ）, 19 cases of postoperative fever （9%）. 196 cases were followed up after 3 -6 months, average 4 months, no stone recurrence. Conclusion The stone-breaking and suction system combined with ultrasonography in trea- ting upper urinary calculi by using single channel minimally invasive percntaneous nephrolithotomy with high success rate, convenient, safe, is a method of minimally invasive and efficient, and has important clinical appli- cation value.