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目的探讨超声定位微创经皮肾输尿管镜气压弹道碎石取石术治疗肾结石及输尿管上段结石的疗效及安全性。方法 320例患者,肾结石263例,输尿管上段结石57例。肾结石大小直径1.2～5.2 cm,输尿管上段结石大小直径0.8～1.2 cm。采用超声定位微创经皮肾输尿管镜气压弹道碎石取石术治疗。结果 320例中B超定位穿刺成功300例。超声定位成功率93.75%。一期碎石并成功取净结石176例,二期取净69例,结石总取净率77.53%。手术时间1～4.5h,平均2.1h。术中出血约10～400 ml,平均50ml,术中输血5例。术中未出现严重并发症,中转开放手术4例。结论超声定位微创经皮肾穿刺造瘘气压弹道碎石取石术治疗肾结石及输尿管上段结石具有目标准确、肾组织损伤小、术中安全、结石清除率高等优点。
Objective To investigate the efficacy and safety of ultrasound-guided minimally invasive percutaneous nephroureteroscopic pneumatic lithotripsy in the treatment of renal calculi and upper ureteral calculi. Methods 320 patients, 263 cases of kidney stones, 57 cases of upper ureteral calculi. The diameter of kidney stones is 1.2 ~ 5.2 cm in diameter, and the diameter of upper ureteral stones is 0.8 ~ 1.2 cm in diameter. Ultrasound-guided minimally invasive percutaneous nephroureteroscopic pneumatic lithotripsy lithotripsy. Results of 320 cases of B-positioning puncture was successful in 300 cases. Ultrasound localization success rate of 93.75%. A gravel and net stones were successfully taken in 176 cases, 69 cases of the second phase, the total stone removal rate of 77.53%. Operation time 1 ~ 4.5h, an average of 2.1h. Intraoperative bleeding about 10 ~ 400 ml, an average of 50ml, intraoperative blood transfusion in 5 cases. No serious complications during surgery, 4 cases of open surgery. Conclusion Ultrasound-guided minimally invasive percutaneous nephrolithotomy with pneumatic lithotripsy for the treatment of renal stones and upper ureteral calculi has the advantages of accurate target, less renal tissue damage, intraoperative safety and high rate of stone clearance.