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目的:评价B超引导下经皮肾镜超声联合气压弹道碎石术治疗复杂性肾结石的临床疗效。方法:对2006年3月～2008年6月,采用B超引导下经皮肾镜超声联合气压弹道碎石术治疗90例96侧复杂性肾结石患者的手术时间、结石清除率、手术并发症等临床资料进行回顾性分析。结果:所有患者均成功建立F24皮肾通道并Ⅰ期碎石,平均手术时间70min,平均结石处理时间为50min。本组未出现气胸、肠道损伤等手术并发症。术后复查KUB平片,83例肾脏结石清除干净,净石率92%;7例肾脏有结石残留,辅助ESWL治愈。随访1～6个月,无严重手术并发症。结论:B超引导下经皮肾镜超声联合气压弹道碎石术处理复杂性肾结石具有高效、安全的特点,值得临床推广应用。
Objective: To evaluate the clinical effect of percutaneous nephrolithotomy combined with pneumatic lithotripsy in the treatment of complicated renal calculi under B-guided ultrasonography. Methods: From March 2006 to June 2008, 90 patients with 96-sided complex renal calculi underwent B-guided percutaneous nephroscope and pneumatic lithotripsy for operation time, stone clearance rate and surgical complications Clinical data such as retrospective analysis. Results: All patients were successfully established F24 renal artery and gravel Ⅰ, the average operation time 70min, the average treatment time for stones 50min. This group did not appear pneumothorax, intestinal injury and other surgical complications. Postoperative KUB plain film review, 83 cases of kidney stones removed, the net rate of 92%; 7 cases of kidney residual stones, assisted ESWL cure. Follow-up 1 ~ 6 months, no serious surgical complications. Conclusion: B ultrasound guided percutaneous nephroscope combined with pneumatic lithotripsy for complex renal calculi has the characteristics of high efficiency and safety, which is worthy of clinical application.