经皮肾镜钬激光加气压弹道碎石治疗上尿路结石

目的探讨经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)钬激光加气压弹道碎石术(pneumatic lithotripsy,PL) 激光碎石术(laser lithotripsy,LL)治疗上尿路结石的疗效。方法回顾性分析76例经皮肾镜下PL LL治疗的上尿路结石患者的临床资料。结果平均手术时间86min,术中出血量50～600mL,术后血尿时间1～5d,1例术后第2天行选择性肾动脉栓塞止血。PL LL一期结石清除率为71.1%(54/76),二期结石清除率80.0%(12/15),体外冲击波碎石术处理残留结石4例。结论经皮肾镜钬激光碎石加气压弹道碎石治疗上尿路结石安全、有效。

Treatment of upper urinary tract stone under percutaneous nephrolithotomy with pneumatic lithotripsy and holmium: YAG laser lithotripsy

Objective To evaluate the clinical effect of percutaneous nephro-lithotomy with pneumatic lithotripsy and holmium:YAG laser lithotripsy for upper urinary tract stone. Methods The clinical data of 76 cases of upper urinary tract stone treated under percutaneous nephrolithotomy(PCNL) with pneumatic lithotripsy and holmium:YAG laser lithotripsy was analysed retrospectively. Results Average operation time was 86 minutes, blood loss volume of operation was between 50 mL to 600 mL, time of blood urine was one to five days, one accepted selectivity thrombosis of renal artery in 2nd day after operation, the first stage stone-free rate was 71.1% (54/76), the second stage of stone free rate was 80.0% (12/15), and four patients aceepted ESWL for residual stone. Conclusions Percutaneous nephrolithotomy with pneumatic lithotripsy and holmium:YAGlaser lithotripsy for upper urinary tract stone is a safe and effective technique.