B超引导下标准通道经皮肾镜气压弹道联合超声碎石治疗复杂性肾结石

目的评价B超引导下建立标准穿刺通道经皮肾镜气压弹道联合超声碎石清石术（PCNL）治疗复杂肾结石的疗效。方法自2006年12月-2009年1月治疗123例128侧肾结石患者，B超引导下建立标准经皮肾穿刺通道，行经皮肾镜下气压弹道联合超声碎石清石术。结果123例患者128侧患肾均Ⅰ期成功建立经皮肾通道，其中3例患者同侧患肾工期建立2个经皮肾通道，1例建立经皮肾通道过程中出血，留置肾造瘘管后改Ⅱ期手术。123例128侧患肾1次取净结石116例，结石清除率90．63％。3例结石残留者1周后再次行PCNL碎石清石术，6例患者有直径小于1cm结石残留，术后行体外冲击波碎石（ESWL）治疗，3例微小结石残留患者予以排石治疗。6例患者出现菌血症，1例患者出现腹膜后血肿，予以对症处理后均治愈出院。所有病例均随访1～24个月，无结石复发。结论B超引导下建立标准穿刺通道行经皮肾镜气压弹道联合超声碎石清石术治疗肾结石具有高效、耗时短、安全等特点，值得临床推广应用。

Percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B ultrasound guidance in standard access for treatment of complex renal calculi

Objective To evaluate the safety and efficacy of combined pneumatic and ultrasound lithotripsy in percutaneous nephrolithotomy(PCNL) for complex renal calculi under B ultrasound guide.Methods From December 2006 to January 2009,123 patients(128 kidneys) were treated by combined pneumatic and ultrasound lithotripsy in PCNL,with the standard percutaneous renal access established by B ultrasound guide.Results The standard percutaneous renal access was successfully established in all patients.3 patients had two ...