单用B超引导经皮肾镜碎石术治疗上尿路结石318例分析

摘要

目的探讨单用B超引导经皮肾镜碎石术治疗上尿路结石的临床疗效。方法总结分析我院单用B超引导经皮肾镜下应用第三代气压弹道碎石治疗上尿路结石318例的临床资料。结果318例均一期成功建立皮肤肾脏通路。平均手术时间85min，术中出血平均100mL，术后平均住院时间5.5d，1次取净结石286例，2次取净4例，总结石清除率为91.2%，无气胸、腹腔脏器损伤等并发症发生。结论单用B超引导经皮肾镜碎石术是治疗上尿路结石的一种微创、安全、有效的方法。%Objective To evaluate the clinical efficacy of treatment of upper urinary tract calculi by percutaneous nephrolithotripsy (PCNL) under single B-type ultrasound guidance. Method We retrospectively investigated 318 cases who underwent PCNL using the forth generation Swiss LithoClast Master for upper urinary tract calculi from June 2009 to June 2010.Clinical data including operation time, stone free rate and complications were analyzed. Results The percutaneous renal access was successfully established under B type ultrasound guidance in all patients, immediate phaseⅠlithotripsy was performed in 313 cases and delayed phaseⅡlithotripsy in 5 cases. The average operation time was 85 minutes (ranged from 60 to 190 minutes), severe complications did not occur during nephrolithotripsy. Stone free rate was 91.2% (290/318). Conclusion PCNL under single B type ultrasound guidance is a minimally-invasive, secure and efficient treatment for upper urinary tract calculi.