迷你肾镜下联用超声和气压弹道碎石治疗上尿路复杂性结石56例

目的探讨经皮迷你肾镜下超声碎石联合气压弹道碎石术（Mini-PCNL）治疗肾、输尿管上段复杂性结石的临床疗效。方法在B超引导下经皮肾穿刺造瘘，在F20．8迷你肾镜下应用组合式超声碎石和气压弹碎石机（Swiss Lithoclast Master）将结石击碎，并同时将碎石块吸出体外。结果56例患者，50例一期取净结石，6例肾盏内小块结石残留，经软性肾镜取石或体外震波碎石（ESWL）后治愈。平均手术时间90min，术中结石清除率89．3％，无严重手术并发症。结论迷你肾镜下超声和气压弹道碎石术具有高效、微创和结石清除率高之优点，可作为治疗肾、输尿管上段复杂结石的重要疗法。

Combined ultrasound and pneumatic iithotripsy for the treatment of upper urinary tract stones during mini-percutaneous nephrolithotomy

ObjectiveTo evaluate the curative effects of renal or upper ureteral stones by means of combined ultrasound and pneumatic lithotripsy during mini-percutaneous nephrolithotomy(Mini-PCNL).MethodsMini-percutaneous nephrostomy under ultrasonography was performed.Stones were broken into small pieces by combined ultrasound and pneumatic lithotriptor(Swiss Lithoclast Master)and evacuated with suction at the mean time.ResultsIn the 56 cases,stones were cleared off at one section in 50 cases,and six cases with residual stones were cured by soft nephroscopes or ESWL.The average time of surgery was 90 minutes and the stone clearance rate was 89.3%.No severe complication occurred during operations.ConclusionSwiss Lithoclast Master appears to be a good effective and minimal invasive device with high stone clearance rate.Mini-PCNL is believed to be a important method for the treatment of renal or upper ureteral complicated stones.