肾盂切开配合气压弹道碎石治疗巨大肾结石体会

目的:探讨肾盂切开配合气压弹道碎石技术治疗巨大肾盂及肾铸型结石的临床疗效。方法:在肾盂切开取石中配合气压弹道碎石技术治疗18例巨大肾盂及肾铸型结石患者,并对手术效果进行临床跟踪观察。结果:18例患者均取石成功。平均手术时间152 mim,术中平均出血量110 mL。术后3周后行B超、KUB或IVP复查,结石一次性取净16例(16/18),2例(2/18)肾盏内分别残留0.7 cm×0.6 cm小结石及沙样结石。结论:肾盂切开配合气压弹道碎石治疗巨大肾结石,可避免行肾实质切开,减少肾功能损害及术中出血量,降低复杂肾结石的手术难度和手术风险,降低结石残余率,实现一机多用,值得推广应用。

Experience of curing the huge renal calculi with pyelotomy and air pressure lithotripter

Objective: To investigate the effect of pyelotomy matching air pressure lithotripter in the treatment of huge and staghorn renal calculi.Methods: A summary of treating 18 cases of patients with huge and staghorn renal calculi who treated by pyelotomy matching air pressure lithotripter was made and the clinical effects were follow-up analyzed.Results: All stones were fragmented successfully,the average operative duration was 152 min and the average intraoperative blood loss was 110 ml.Three weeks after,the results of ultrasonic examination or KUB or IVP showed that the stones of 16 cases were cleared out completely.2 cases had residual stones(diameter=0.7cm×0.6cm) inside renal calyx.Conclusion: The pyelotomy matching air pressure lithotripter treating the the patient with huge and staghorn renal calculi can avoid intrarenal surgery,decrease haemorrhage and functional damage of the kidney.It is worthy to be popularized because of decreasing the difficulty and risks of the complicated renal calculus operation and the residual stones rate.