经皮肾镜气压弹道碎石术治疗上尿路结石310例临床剖析.docVIP

经皮肾镜气压弹道碎石术治疗上尿路结石310例临床剖析 　　【摘要】 目的 探讨经皮肾输尿管镜气压弹道碎石术治疗肾脏与输尿管上段结石的方法与疗效。方法 采用经皮肾输尿管镜下气压弹道碎石术治疗上尿路结石310例。结果 2004年3月至2007年12月，采用I期、Ⅱ期或分步经皮肾输尿管镜手术成功处理310例上尿路结石，其中包括鹿角型结石、多发性肾结石、孤立肾结石、ESWL（体外震动破碎石术）治疗失败、开放取石手术后复发、输尿管上段结石。肾结石清除率为91．28%，输尿管结石清除率为89．85%,且无严重手术并发症发生。结论 经皮肾输尿管镜气压弹道碎石术治疗上尿路结石具有微创、恢复快、并发症少、安全高效、结石清除率高的优点。 　　【关键词】 肾结石；输尿管结石；内窥镜术；碎石术 　　 　　Clinical analysis of technique and efficacy of 310 percutaneous nephrolithotomy cases combinned pneumatic lithotripsy JIANG Lei，ZHANG Jun，ZENG Chun．ming,et al.Department of Urology，the Peoples Hospital of YongZhou，Hunan Province 425006,China 　　【Abstract】 Objective To investigate and assess the clinical technique and efficacy of minimally invasive percutaneous nephrolithotomy combined contact pneumatic lithotripsy for upper urinary lithiasis treatment．Methods 310 patients with upper urinary calculi underwent minimally invasive percutaneous nephrolithotomy combined contact pneumatic lithotripsy．Results From Mar 2004 to Dec 2007，310 patients underwent I，II period or two．step percutaneous nephrolithotomy using a combined pneumatic lithortite，including renal stag horn stone，poly kidney calculi，solitary kidney calculi，ESWL failure calculi，recurrent calculi after open surgery and upper ureterie calculi．Clinical data was analyzed retrospectively，stone clearance rate was91．28%and 89．85%for kidney and ureterie stone，respectively.No serious surgery．concerned complication occurred during nephrolithotomy.Conclusion The minimally invasive percutaneous nephrolithotomy combined pneumatic device appears to be minimally invasive，quick recovery，less complication，eficacious，safe and high stone．free rate for upper urinary calculi remove． 　　【Key words】 Kidney calculus；Ureteral calculi；Endoscopic lithotripsy；Percutaneous nephrolithotomy 　　 　　2004年3月至2007年12月，笔者对310例上尿路结石采用B超定位下经皮肾穿刺造瘘，采用I期、Ⅱ期或分步经皮肾输尿管镜下气压弹道碎石术治疗，取得良好疗效，现总结如下。 　　 　　1 资料与方法 　　 　　1．1 一般资料 本组310例，男167例，女143例，年龄18~72岁，平均(42．5±14．5)岁。双侧上尿路结石行双侧经皮肾输尿管镜处理21例，单侧肾铸型结石40例，多发肾结石72例，