经皮肾镜钬激光联合超声碎石治疗鹿角形肾结石:附36例报告

目的探讨经皮肾镜取石术(PCNL)钬激光联合超声碎石治疗鹿角形肾结石的可行性和疗效。方法 2010年4月至2011年5月,我院共对36例鹿角形肾结石实施了PCNL钬激光联合超声碎石治疗。首先建立22F的手术通道,钬激光快速将结石击碎为10mm内碎石,再通过超声碎石将结石清除,对于需要建立的的其他通道均采用18F或16F的微通道。结果手术均取得成功,单通道取石29例,双通道取石7例,平均手术时间105min。一次手术取净结石26例(72.2%),二次手术联合体外冲击波碎石取石术(ESWL)治疗7例。术后随访1～3个月,总无石率91.7%,无严重并发症发生。结论 PCNL联合钬激光和超声碎石治疗鹿角形肾结石具有清石效率高、手术时间短、无石率高、并发症少等优点。

Percutaneous nephrolithotomy combined holmium laser with ultrasound for treatment of renal staghorn stones:A report of 36 cases

Objective To investigate the feasibility and effectiveness of percutaneous nephrolithotomy(PCNL) through the combination of holmium laser and ultrasound for treatment of renal staghorn stones.Methods From April 2010 to May 2011,a total of 36 patients with renal staghorn stones underwent PCNL combind holmium laser with ultrasound.First,22 F channeles were eslablished and stones crushed to fragments(<10 mm) with holmium laser.Then,ultrasound was used to remove fragments.18 F or 16 F channel were adopted for other accesses.Results All surgeries were successfully performed,29 through a single tract,7 through two tracts respectively.The average time of lithotripsy was 105 min.No significant complications were observed.Conclusions Percutaneous nephroslithotomy with holmium laser and ultrasoun could reduce the duration of operation.It is efective and safe for complicated kidney stones.The combination of holmium laser and ultrasound deserves being used in PCNL for renal staghorn stones.