【摘要】 目的 评价超声引导标准通道经皮肾镜下气压弹道碎石联合超声碎石(PCNL)治疗复杂性肾结石的效果。方法 超声引导标准通道 PCNL 治疗复杂性肾结石病人29例,其中结石直径>2.5 cm者25例,鹿角形结石18例,多发结石23例,感染性结石2例,孤立肾结石3例。结果 单通道取石26例,双通道取石2例, 中转开放手术1例，结石清除率为71.4%(20/28)。手术时间为40～260 min，平均130 min。术中出血1例放置肾造瘘管改二期手术。术后除1例因肾动静脉瘘行肾动脉栓塞，未发生术后大出血及感染情况。结论 超声引导下标准通道 PCNL治疗复杂性肾结石安全、有效;对于严重并发症应足够重视，并随时做好应对措施。
【关键词】 碎石术;肾造口术,经皮;肾结石;治疗结果
TREATMENT OF COMPLEX RENAL CALCULUS BY ULTRASOUNDGUIDED PERCUTANEOUS NEPHROLITHOTOMY COMBINED WITH PNEUMATIC AND ULTRASONIC LITHOTRIPSY YU QINCHAO, SHAO SHIXIU, HOU SICHUAN, et al(Department of Urology, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China); [ABSTRACT] Objective To evaluate the effects of ultrasoundguided percutaneous nephrolithotomy (PCNL) combined with pneumatic and ultrasosonic lithotripsy in the treatment of complex renal calculus. Methods This tecnique was applied in 29 patients with complex renal stone, of whom, the size of stone of >2.5 cm was found in 25 cases, staghorn sone in 18, multiple stones in 23, infective stone in two, and stone in solitary kidney in three cases. Results Singlechannel technique was used in 26 cases, dualparthway in two. The total stone clearnace was 71.4% (20/28). The mean time spent (range) in operation was130 min (40-260). Nephrostomy was done in one case due to intraoperative bleeding, who was scheduled for secondstage surgery. Postoperatively, embolization of renal artery was done in one cases due to renal arteriovenous fistula. No postoperative hemorrhage or infection was recorded. Conclusion The combined technique used in this study is effective and safe for complex renal calculus. A great attention shoud be paid to severe complications and coping measures be prepared any time.
[KEY WORDS] Lithotripsy; Nephrostomy, percutaneous; Kidney stone; Treatment outcome
复杂性肾结石应用体外冲击波碎石(ESWL)治疗效果不佳，开放手术取石并发症较多，而经皮肾镜下气压弹道碎石联合超声碎石(PCNL)治疗
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