经皮肾镜联用气压弹道碎石和超声碎石术治疗复杂性上尿路结石18例

目的总结经皮肾镜联用气压弹道碎石和超声碎石治疗肾、输尿管上段结石的临床价值。方法在B超引导下经皮肾穿刺造瘘，并将通道扩张至F21，从造瘘通道插入肾镜到结石处，用气压弹道碎石联合超声碎石将结石击碎，并将碎石吸出。结果18例患者中有15例为一期取净结石；3例肾多发结石或铸形结石息者结石残余，经体外震波碎石（ESWL）或软性肾镜取石后治愈。结论经皮。肾镜联用气压弹道碎石和超声碎石术疗效佳、损伤小，安全性较高，可作为治疗肾、输尿管上段复杂结石的重要方法。

Combined pneumatic and ultrasound lithotripsy for the treatment of upper urinary tract stones during percutaneous nephrolithotomy

Objective To evaluate the curative effeets of renal or upper urcteral stones by means of combined pneumatic and ultrasound lithotripsy during percutaneous nephrolithotomy. Methods Percutaneous nephrostomy under ultrasonography was performed, The tracts were dilated to 21F, Through theses tracts,stones were broken into small pieces by pneumatic lithotriptor combined pneumatic and ultrasound lithotripsy, Results In the 18 cases , the stones were cleared off at one section in 15 cases, and three cases with residual stones were cured by ESWL or softnephroscope. Conclusion The new lithotripter is believed to be a minimal invasive and good effective method for the treatment of renal or upper ureteral stones. The result would be better if PCNL combined with ESWL.