论文部分内容阅读
目的探讨经皮肾镜钬激光碎石取石术(PCNL)治疗上尿路结石的疗效及作用。方法对从2004年10月～2009年10月应用PCNL技术治疗上尿路结石412例进行分析。患侧逆行置管后,在C臂X光引导(77例)或B超引导下(335例)进行穿刺,以筋膜扩张器递增扩张建立18～26 F皮肾操作通道,以输尿管硬镜或肾镜用钬激光碎石机将结石击碎、取出,常规留置肾造瘘管。结果 412例中有391例(94.9%)一期碎石及取石,21例(5.1%)行二期碎石或取石。其中单通道取石392例(95.1%),双通道取石20例(4.9%)。平均结石清除率87.7%,平均手术时间130 min,肾造瘘管平均留置5 d,平均术后住院时间6.5 d。结论 PCNL治疗上尿路结石安全、高效,具有对患者创伤小、恢复快、结石清除率高等优点,是治疗上尿路结石的安全有效的方法之一。
Objective To investigate the efficacy and effect of percutaneous nephrolithotomy with holmium laser lithotripsy (PCNL) in the treatment of upper urinary tract calculi. Methods From October 2004 to October 2009, PCNL technique was used to treat 412 cases of upper urinary tract stones. After ipsilateral retrograde catheterization, C-arm X-ray guidance (n = 77) or B-ultrasound guidance (n = 335) was used to perform puncturation with an incremental dilation of fascia dilator to establish 18-26 F renal access. Nephrolithotomy with holmium laser lithotripsy crushed stone, remove, conventional indwelling renal fistula. Results Of 412 cases, 391 cases (94.9%) had gravel and stone, and 21 cases (5.1%) had gravel or stone. Among them, 392 cases (95.1%) were single-channel stone and 20 cases (4.9%) were double-channel stone. The average stone clearance rate was 87.7%, the average operation time was 130 min. The average diameter of renal fistula was 5 days, and the average postoperative hospital stay was 6.5 days. Conclusion PCNL treatment of upper urinary tract stones safe and efficient, with small trauma to patients, rapid recovery, the advantages of high stone removal rate is one of the safe and effective treatment of upper urinary tract stones.