经皮肾镜第四代EMS超声气压弹道碎石清石系统治疗复杂性肾结石效果

TREATMENT OF COMPLEX RENAL CALCULUS BY ULTRASOUND-GUIDED PERCUTANEOUS NEPHROLITHOTOMY COMBINED WITH PNEUMATIC AND ULTRA- SONIC

目的：评价超声引导标准通道经皮肾镜下第四代EMS超声气压弹道碎石清石系统治疗复杂性肾结石的效果。方法：超声引导标准通道PCNL治疗复杂性肾结石病人16例，其中结石直径〉2．5cm者9例，鹿角形结石6例，多发结石9例，感染性结石1例，孤立肾结石1例。结果：单通道取石15例，双通道取石1例，结石清除率为75％（12／16）。手术时间为40～180min，平均120min。术中出血1例放置肾造瘘管改二期手术。术后除1例因肾动静脉瘘行肾动脉栓塞，未发生术后大出血厦感染情况。结论：超声引导下标准通道PCNI。治疗复杂性肾结石安全、有效；对于严重并发症应足够重视，并随时做好应对措施。

Objective To evaluate the effects o{ ultrasound-guided percutaneous nephrolithotomy （PCNL） combined with pneumatic and ultrasosonic lithotripsy in the treatment of complex renal calculus. Methods This tecnique was applied in 16 patients with complex renal stone, of whom, the size of stone of 〉2.5 cm was found in 9 cases, staghorn sone in 6, multiple stones in 9, infective stone in one, and stone in solitary kidney in one cases. Results Single-channel technique was used in 15 cases, dual-parthway in one. The total stone clearnace was 75 ~ （12/16）. The mean time spent （range） in operation wasl20 rain （40-- 180）. Nephrostomy was done in one case due to intraoperative bleeding, who was scheduled for second stage surge-ry. Postoperatively, embolization of renal artery was done in one cases due to renal arteriovenous fistula. No postoperative hemorrhage or infection was recorded. Conclusion The combined technique used in this study is effective and safe for complex renal calculus. A great attention shoud be paid to severe complications and coping measures be prepared any time.