Objective To analyze the cause and efficacy of two - stage percutaneous nephrolithomy( PCNL ) combined with pneumatic and ultrasound lithotripsy. Methods All 81 cases treated by two - stage percutaneous nephrolithotripsy combined with the using of pneumatic and ultrasonic system ( EMS IV ) were reviewed retrospectively. Results Of 81 cases treated with two stage PCNL, 54 cases had residual stones after one session PCNL, 10 cases had bleeding, 8 cases suffered from pelvic pyonephrosis, 2 cases had severe fever during operation, 2 cases could not cope with operation, and 5 cases had serious complications before surgery. The mean time of the operation was 45 minutes (25-64 min ). The average blood loss was 35 ml ( 20 - 105 ml ). The calculi clearance rate was 85. 2%. There was no severe bleeding, fever and severe infection. Conclusion The two stage PCNL after rational selection by B -type ultrasound guidance can improve the efficacy of the calculi clearance. The remaining stone is the main cause of two - stage PCNL. Preoperative angiography, CT examination and the intraoperative application of B type ultrasound can reduce effectively the incidence of residual stones.%目的 探讨超声引导下经皮肾镜气压弹道联合超声二期取石术的原因及疗效评价.方法 回顾分析经皮肾镜气压弹道联合超声二期取石术81例患者的临床资料.结果 81例患者中,结石残留54例,出血10例,脓肾8例,高热2例,术中不能配合者2例,严重合并症者5例.平均手术时间45 min(25～64 min),平均出血量35 ml(20~105 ml),结石清除率85.2%,无大出血、发热及严重感染.结论 合理选择二期手术可提高经皮肾镜取石术的成功率.结石残留是经皮肾镜二期手术的主要原因,术前造影、CT检查以及术中B超的应用可提高结石的清除率.
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