B超引导下经皮肾镜钬激光碎石术治疗上尿路结石的疗效

目的:探讨B超引导建立皮肤肾脏通路,行经皮肾镜联合钬激光治疗上尿路结石的安全性和临床疗效。方法:2005年4月至今采用B超引导穿刺建立通路,行经皮肾镜联合钬激光治疗上尿路结石患者117例,并记录碎石取石时间、结石取净率及手术并发症。结果:117例患者均一期成功建立皮肤肾脏通路,102例行一期碎石术,15例行二期碎石术。碎石手术时间80～150min。1例患者术后输血800ml,无气胸、腹腔脏器损伤等严重并发症发生。术后复查,98例患者排净结石,19例有结石残余,结石清除率为83.8%(98/117)。结论:采用B超引导穿刺经皮肾镜碎石术治疗上尿路结石安全、方便,疗效可靠。

Percutaneous nephrolithotripsy with holmium laser under ultrasound guidance for the treatment of upper urinary tract lithiasis

Objective:To evaluate the efficacy and safety of management of calculus of upper urinary tract by percutaneous nephrolithotripsy(PCNL) with holmium laser under ultrasound guidance.Methods:From Apri1 2005 to Apri1 2007, 117 cases of patients with upper urinary tract calculus received percutaneous nephrolithotripsy. The duration of stone surgery,stone-free rate and complication were assessed.Results:The percutaneous renal access was successfully established under ultrasound guidance in all patients. Immediate phase I lithotripsy was performed in 102 cases and delayed phase II lithotripsy in 11 cases. Operation time ranged from 80 to 150 minutes. Blood transfusion was needed in 1 case. No severe complications were noted during nephrolithotripsy. Stones were cleared in 98 out of 117 cases(83.8%) during immediate phase I lithotripsy. Residual stone fragments were found in 19 cases who received second PCNL or adjuvant extracorporeal shock wave lithotripsy.Conclusions:The management of upper urinary tract calculus using PCNL appears to be efficacious and safe under ultrasound guidance.