B超引导经皮肾镜气压弹道超声联合碎石治疗肾结石的临床研究

目的探讨B超引导经皮肾镜气压弹道超声联合碎石治疗肾结石的临床效果。方法选取2009年10月～2012年6月本院收治的肾结石患者106例,经B超引导下穿刺目标肾盏,以建立皮肤肾脏通道,然后在肾镜下采用气压弹道联合超声碎石术,观察患者的手术时间、出血量、结石清除率以及术后有无严重感染、腹腔脏器损伤等严重并发症。结果所有患者均成功建立皮肤肾脏通道,其中,95例行一期碎石术,11例行二期碎石术。患者的手术时间为70～140min,平均（89±13）min,患者出血量为15～150ml,平均（72±11）ml,术后7d复查发现有92例患者结石清除成功,结石清除率为86.8%,术后患者均无严重感染,无腹腔脏器损伤等严重并发症;未清除成功的结石患者经体外冲击波碎石治疗,全部痊愈。结论 B超引导经皮肾镜气压弹道超声联合碎石治疗肾结石手术成功率较高,术后并发症少,安全可靠,具有很好的疗效,值得在临床中推广应用。

The clinical studies of B ultrasound-guided percutaneous nephrolithotomy air pressure ballistic combined with ultrasound lithotripsy in treatment of kidney stones

Objective To investigate the clinical efficacy of B ultrasound-guided percutaneous nephrolithotomy air pressure combined with ballistic ultrasound lithotripsy for kidney stones. Methods 106 cases of patients with kidney stones were selected from October 2009 to June 2012 in our hospital,they were given B ultrasound-guided puncture target calyceal skin of kidney channel,then combined with ultrasound in renal en sy,the surgery time,the amount of bleeding,the stone clearance rate,as well as the serious infection,abdominal organ damage doscopic pneumatic ballistic lithotrip- presence or absence of postoperative and other serious complications were observed. Results All the patients were successfully established skin kidney channels,of which 95 cases were given gravel,11 cases were given two lithotripsy. The operative time was 70-140 min, the average time was（89±13） minutes,the amount of bleeding was 15-150 mi, and the average was （72±11）ml,after 7 days,the review found that 92 cases of patients had successful stone clearance,and the stone clearance rate was 86.8%,postoperative patients had serious infections,abdominal organ injuries and other se- rious complications,the remaining patients after extracorporeal shock wave lithotripsy,all healed clear stones to success. Conclusion B ultrasound-guided percutaneous nephrolithotomy air pressure combined with ballistic ultrasonic lithotripsy kidney stone surgery has high success rate,it has fewer complications,and it is safe and reliable,which is worth to be popularized in clinical application.