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目的探讨经皮肾镜气压弹道碎石治疗复杂性上尿路结石的疗效及安全性。方法对476例接受经皮肾镜气压弹道碎石治疗的复杂性上尿路结石患者的临床资料进行了回顾性分析。结果476例患者中471例成功行一期取石术,5例中转开放手术;一期手术取净结石290例,二期手术取净结石83例,三期手术取净结石49例,结石总取净率88.7%,手术时间58-246 min,平均(114±32)min;术中出血量25-610 mL,平均(77±21)mL;肾造瘘管留置时间平均7 d,术后平均住院8.5 d,未出现严重的并发症。结论经皮肾镜气压弹道碎石具有损伤小、恢复快、住院时间短、结石清除率高、并发症少等优点,是治疗复杂性上尿路结石较好的微创方法。
Objective To investigate the efficacy and safety of percutaneous nephroscopic pneumatic lithotripsy in the treatment of complex upper urinary tract calculi. Methods The clinical data of 476 patients with complicated upper urinary tract calculi undergoing percutaneous nephroscopic pneumatic lithotripsy were retrospectively analyzed. Results Among the 476 patients, 471 cases were successfully performed one-stage lithotripsy and 5 cases were converted to open surgery. The first stage was performed with net stones in 290 cases, the second stage with net stones in 83 cases, the third stage with 49 cases of net stones, The average rate of intraoperative bleeding was 25-610 mL (77 ± 21) mL. The mean retention time of renal fistula was 7 days. The average postoperative hospital stay was 88.7%. The mean operative time was 58-246 min (mean, 114 ± 32) min. 8.5 d, no serious complications. Conclusion Percutaneous nephroscopic pneumatic lithotripsy is a minimally invasive method for the treatment of complex upper urinary tract stones with the advantages of small injury, rapid recovery, short hospital stay, high stone clearance rate and few complications.