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目的评价经皮肾镜下气压弹道联合超声碎石术处理复杂性肾结石的疗效。方法回顾性分析2006年2月～2007年1月采用经皮肾镜下气压弹道联合超声碎石术治疗的复杂性肾结石42例44侧临床资料。结果42例患者均成功建立皮肾通道,采用一期单通道碎石39例,行一期两通道碎石3例。全组行一期碎石术37例,行二期碎石术5例。手术时间25～130min,平均(80±10)min,结石处理时间平均为(58±9)min,结石清除率88.1%(37/42)。5例多发性结石患者结石残留,经原通道二期碎石2例,ESWL3例,均获治愈。1例患者因术中大出血输浓缩红细胞3U。随诊1～9月,无严重手术并发症。结论经皮肾镜下气压弹道联合超声碎石术处理复杂的肾结石,具有疗效佳、安全性高、损伤小、结石清除率高的优点,值得临床推广应用。
Objective To evaluate the efficacy of percutaneous nephrolithotomy combined with ultrasonic lithotripsy in the treatment of complex renal calculus. Methods A retrospective analysis of 44 cases of 42 cases of complicated renal calculus treated with pneumatic lithotripsy and ultrasonic lithotripsy from January 2006 to January 2007 was performed. Results 42 cases of patients were successfully established renal access, with a single-pass 39 cases of gravel, a two-stage gravel in 3 cases. The whole group of 37 cases of a lithotripsy, two cases of lithotripsy in 5 cases. The operation time was 25 ~ 130min, with an average of (80 ± 10) min. The mean time of stone treatment was (58 ± 9) min and the stone clearance rate was 88.1% (37/42). Five cases of stone in patients with multiple stones remain, the original passage of two gravel in 2 cases, ESWL 3 cases, were cured. One patient lost 3U of erythrocytes due to intraoperative hemorrhage. Follow-up 1-9 months, no serious surgical complications. Conclusions Percutaneous nephrolithotomy combined with ultrasonic lithotripsy in the treatment of complex renal calculi has the advantages of good curative effect, high safety, small injury and high stone clearance rate, which is worthy of clinical application.