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目的探讨经皮肾镜下气压弹道碎石加超声碎石取石术处理复杂性肾结石的疗效。方法2004年10月至2005年3月,采用经皮肾镜下气压弹道碎石联合超声碎石取石术I期治疗复杂性肾结石28例34侧。结果手术时间平均80 min,结石处理时间60 min,结石清除率91.1%;4例多发性结石或铸形结石患者远处肾盏内有直径小于1 cm残留小结石,辅助施行体外冲击波碎石治疗。所有病例随访1~3个月,均无严重手术并发症。结论经皮肾镜下气压弹道碎石加超声碎石取石术治疗较大的复杂性肾结石安全、高效、容易操作,且结石清除率高,值得临床推广应用。
Objective To investigate the efficacy of percutaneous nephrolithotomy with pneumatic lithotripsy and ultrasonic lithotripsy in the treatment of complex renal calculus. Methods From October 2004 to March 2005, 28 cases of complicated renal calluses were treated with percutaneous nephroscopic pneumatic lithotripsy and ultrasonic lithotripsy. Results The average operation time was 80 min, the stone treatment time was 60 min and the stone removal rate was 91.1%. In 4 patients with multiple calculi or cast stone, there were residual small stones less than 1 cm in diameter in the calyceal calculus, which assisted the use of extracorporeal shock wave lithotripsy . All cases were followed up for 1 to 3 months, no serious surgical complications. Conclusion Percutaneous nephrolithotomy with pneumatic lithotripsy and ultrasonic lithotripsy is safe, effective and easy to operate for the treatment of large complex renal calculi. The stone clearance rate is high, which is worthy of clinical application.