超声引导经皮肾镜气压弹道联合超声碎石治疗马蹄肾结石的效果

目的:评价超声引导经皮肾镜气压弹道联合超声碎石术治疗马蹄肾结石的效果。方法:46例马蹄肾结石患者行经皮肾镜气压弹道联合超声碎石术治疗,对其手术和住院时间,术中和术后并发症以及结石清除情况等进行分析。结果:46例患者Ⅰ期均成功建立经皮肾通道。平均住院5.0～17.0(6.9±1.8)d,手术时间为46～121(75±24)min,结石处理时间为31～68(49±17)min,失血量为28～92(60±31)mL,患者围手术期无输血;Ⅰ期结石清除率为82.6%(38/46),Ⅰ+Ⅱ期结石清除率为91.3%(42/46),2例术后辅助体外冲击波碎石,总结石清除率为95.7%(44/46)。未出现与碎石相关的并发症。结论:超声引导经皮肾镜气压弹道联合超声碎石术治疗马蹄肾结石疗效好。

Efficacy of percutaneous nephrolithotomy with pneumatic and ultrasonic lithotripsy guided by ultrasound for horseshoe kidney with calculi

Aim:To investigate the feasibility of percutaneous nephrolithotomy(PCNL) with pneumatic and ultrasonic lithotripsy under ultrasound guidance for horseshoe kidney with calculi.Methods:Clinical data of 46 cases of horseshoe kidney with calculi treated by PCNL with pneumatic and ultrasonic lithotripsy under ultrasound guidance were retrospectively analyzed.Results:The 46 cases were successfully established artificial calculus-extracting passage with one-stage operation.The average hospitalization time was 5.0～17.0(6.9±1.8) days,operation time was 46～121(75±24) min,calculi processing time was 31～68(49±17) min,and the average blood loss was 28～92(60±31) mL.All patients did not transfuse blood;calculi-free rate was 82.6%(38/46) with one-stage operation,and that was 91.3%(42/46) with two-stage operation.Two cases accepted postoperative adjuvant extracoporeal shock wave lithotripsy,and total calculi clearance rate reached 95.7%(44/46).There was no associated complication.Conclusion:PCNL with pneumatic and ultrasonic lithotripsy under ultrasound guidance is safe and reliable for horseshoe kidney with calculi.