经皮肾镜气压弹道联合超声碎石术治疗孤立肾结石

目的探讨经皮肾镜气压弹道联合超声碎石术治疗孤立肾结石的方法与疗效。方法 21例孤立肾结石患者,在X线引导下建立经皮肾镜操作通道,采用瑞士EMS第三代气压弹道联合超声碎石清石系统治疗肾结石;对手术时间,结石清除率,手术并发症等资料进行分析。结果采用单通道碎石20例,双通道碎石1例;手术时间43～138min,平均68min。术中出血20～250ml,平均90ml。16例I期手术取净结石,3例Ⅱ期取净结石,总结石清除率90.5%,2例残留结石于术后一月行体外冲击波碎石(ESWL);无大出血、感染性休克、胸腹脏器损伤等严重并发症发生;平均住院时间12天。结论经皮肾镜气压弹道联合超声碎石术治疗孤立肾结石安全有效、创伤小,并发症少、恢复快,值得临床推广。

Percutaneous Nephrolithotomy with Pneumatic and Ultrasonic Power for Treatment of Solitary Renal Stone

Objective To evaluate the technique and the clinic effects of percutaneous nephrolithotomy with pneumatic and ultrasonic power for treatment of solitary renal stone.Methods 21 patients with solitary renal stone were treated with PCNL.Percutaneous tract was established under the guidance of X-ray.The Swiss EMS Lithoclast Master System Ⅲ was used in the treatment of olitary renal stone.Clinical data including the operative time,calculus elimination rate and complications were analysed.Results 20 cases received single tract percutaneous nephrolithotomy,while one case received double tracts.The average operation time was 68 min(43 to 138 min);The average intraoperative hemorrhage was 90 ml(20 to 250 ml).The stones were completely taken at first stage in 16 cases,while at second stage in 2 cases,the total stone-free rate was 90.5%;the other 2 cases with residual stones received extracorporeal shock wave lithotripsy(ESWL) one month after the operation.No serious complications such as massive hemorrhage,septic shock and thoracoabdominal viscera injury were found,the average hosiptal stay time was 12 days.Conclusions Percutaneous pneumatic nephrolithotomy combined with ultrasonic power is a safe and effective method for treatment of solitary renal stone with the advantage of minimal invasiveness and quick recovery,which is worthy of clinical application.