B超引导经皮肾镜气压弹道联合超声碎石术治疗复杂性肾结石

目的:总结B超引导经皮肾镜气压弹道联合超声碎石术治疗复杂性肾结石的方法、疗效及并发症,进一步提高疗效、避免或降低并发症。方法:回顾分析应用B超引导经皮肾镜气压弹道联合超声碎石术治疗复杂性肾结石52侧(49例)患者的临床资料。对其方法、一期治疗效果、手术并发症进行分析总结。结果:单通道取石48侧、双通道取石4侧,手术时间65～170 min。一期治疗成功84.6%(44/52)。无肾切除、腹腔脏器损伤、血气胸并发症,迟发性出血行选择性肾动脉栓塞止血1侧(例)、肾盂输尿管交接处完全离断1侧(例),行输尿管肾下盏吻合治愈。结论:B超引导经皮肾镜气压弹道联合超声碎石术治疗复杂性肾结石手术时间短、一期治疗率高、肾脏受损可能是其易出现的并发症,其发生与术者操作不当有关。

Complexity Renal Calculi Treated by Percutaneous Nephroscope with Ultrasonic Guided and Combination of Ballistic and Ultrasonic Lithotripsy

Objective： To Summarize of methods, therapeutic effect and complication of complexity renal calculi treated by combination of ballislic and ultrasonic lithotripsy, and to further improve efficacy, prevent or reduce complications. Methods：Clinical materials of 49 cases （3 cases with bilater） with complexity renal calculi treated by percutaneous nephroscope with ultrasonic guided and combination of ballistic and ultrasonic lithotripsy were ana lyzed retrospectively. The methods, the effective of the first period therapy and the complication of this treatment were summarized. Results：48 cases were performed with single channel, 4 cases with dual channel. The operation time was 65-170 minutes. The successive rate was 44/52 （84.6%） in first period therapy. The complications, kidney excision, abdominal organ injury and hecnopneumothorax were not found. 1 case （one side） with delayed hemorrhage was cured by selectivity thrombosis of renal artery, 1 case （one side） was underwent anastomose renal inferior calyces and ureter for disrupted completion of the junctlve of pelvis and ureter. Conclusions： The operation time was shorter and successive rate was higher for the complexity renal calculi treated by percutaneous nephroscope with ultrasonic guided and combination of ballistic and ultrasonic lithotripsy. The kidney injured might attribute to the maloperation.