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目的研究经皮肾镜取石(PCNL)的新方法及疗效。方法在B超引导下经皮肾穿刺扩张建立皮肾通道,用19.5F的小口径肾镜下行气压弹道和超声吸附取石治疗58例60侧肾铸型肾结石。结果平均手术时间87min,结石处理时间69min,结石清除率88.3%;另外7例肾多发肾盏结石在与经皮通道相邻的肾盏内有直径<1.1cm的结石1~3颗残留,PCNL术后2周辅以体外冲击波碎石(ESWL)治疗。随访1~10个月,无手术并发症发生。结论B超引导PCN、小口径经皮肾镜下气压弹道超声吸附取石术治疗肾铸型结石具有高效、安全的特点,结石清除率高,值得临床推广应用。
Objective To study the new method and effect of percutaneous nephrolithotomy (PCNL). Methods Percutaneous nephrolithotomy under the guidance of B-ultrasonography was used to establish the renal access. Fifty-eight cases of 60 renal pelvis kidney stones were treated with 19.5F small diameter nephrolithotomy with pneumatic ballistic and ultrasonography. Results The average operation time was 87min, the stone treatment time was 69min and the stone removal rate was 88.3%. Another 7 cases of renal multiple calyceal calculus had 1 ~ 3 residual stones with diameter <1.1cm in the calyces adjacent to the percutaneous channel. PCNL 2 weeks after surgery with extracorporeal shock wave lithotripsy (ESWL) treatment. Follow-up 1 to 10 months, no surgical complications. Conclusions B-guided PCN and small-caliber percutaneous nephrolithotomy using pneumatic ballistic ultrasound in the treatment of renal calculus stone has the characteristics of high efficiency and safety, high rate of stone removal, and worthy of clinical application.