肾窦扩大肾盂切开联合气压弹道碎石治疗肾巨大鹿角形结石(附218例报告)

Pneumatic Lithotripsy for Huge Staghorn Renal Stones through Intrarenal Sinus Extension Pyelostomy (A Report of 218 cases)

目的 提高肾巨大鹿角形结石的手术疗效 ,探讨其手术治疗的最佳方式。 方法 采用肾窦扩大肾盂切开联合气压弹道碎石治疗肾巨大鹿角形结石 2 18例。 结果 所有患者均取石成功 ,平均手术时间 90min。术中无一例输血 ,术后无继发出血和感染等并发症发生。 2 0 0例术后 1～ 3月复查B超 ,10例肾内残余结石 ,直径均 <0 .8cm ,4例自行排出 ,6例经药物治疗后排净。 结论 肾窦扩大肾盂切开联合气压弹道碎石治疗肾巨大鹿角形结石疗效确切 ,操作简便、安全、易掌握。

Objective To investigate the operative treatment which is the best for huge staghorn renal stones. Method 218 cases of huge staghorn renal stones were treated by pneumatic lithotripsy through intrarenal sinus extension pyelostomy. Results Successful removal of the stones were achieved in all the patients. The average operation time was 90 min. Blood transfusion was not required during the operation. Postoperative B ultrasound examination revealed small residual calculi (diameter<0.8 cm) of the 200 patients. Conclusion The method is easy, safe and effective, and it may substitute the ordinary renal parenchymal lithotomy.