论文部分内容阅读
目的:探讨经皮肾镜下超声联合气压弹道碎石术治疗肾及输尿管上段结石的临床疗效。方法:回顾性分析2008年7月~2013年12月我院采用经皮肾镜下气压弹道联合超声碎石术治疗肾及输尿管上段结石患者1 057例。结果:1 057例患者均Ⅰ期成功建立F24经皮肾通道,无穿刺失败及中转开放手术者,其中单通道996例,双通道53例,三通道8例。Ⅰ期碎石920例,Ⅱ期碎石137例;Ⅰ期结石清除率为89.5%(823/920),Ⅱ期碎石后总结石清除率为91.9%(971/1057)。平均手术时间为67(30~130)min,平均碎石时间为37(5~90)min,估计术中失血量平均100(20~500)ml。随访3~36个月,均无严重并发症发生。结论:经皮肾镜下超声联合气压弹道碎石术是治疗肾及输尿管上段结石的有效方法之一,结石清除率较高,手术时间短,并发症少,可明显缩短治疗周期,降低手术费用,值得临床推广。
Objective: To investigate the clinical effect of percutaneous nephroscope combined with pneumatic lithotripsy in the treatment of upper ureter and upper ureteral calculi. Methods: A retrospective analysis of 1 057 cases of renal and upper ureteral calculi treated with pneumatic lithotripsy and ultrasonic lithotripsy in our hospital from July 2008 to December 2013 was retrospectively analyzed. Results: Totally 1 057 patients were successfully established F24 percutaneous renal access, without puncture failure and transfer open surgery, including single-channel 996 cases, 53 cases of double-channel, 8 cases of three channels. One hundred and ninety-nine cases were stage Ⅰ gravel, and 137 cases were stage Ⅱ. The clearance rate of stage Ⅰ stone was 89.5% (823/920). The stone clearance rate after stage Ⅱ gravel was 91.9% (971/1057). The mean operative time was 67 (30-130) min and the average gravel time was 37 (5-90) min. The estimated intraoperative blood loss was 100 (20-500) ml on average. Follow-up 3 to 36 months, no serious complications occurred. Conclusion: Percutaneous nephroscope combined with pneumatic lithotripsy is an effective method for the treatment of upper ureteral calculi. The high rate of stone removal, short operative time and less complications can shorten the treatment cycle and reduce the cost of operation , It is worth clinical promotion.