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目的:探讨在经皮肾穿刺取石术中影响肾结石一次清除率原因,并提出相应的对策。方法:在对435例肾结石患者行经皮肾穿刺取石术的不同的时间段,分别使用B超或X线引导、气压弹道或钬激光碎石、俯卧位或侧卧位等方法。结果:不同的时间段、结石和方法导致结石的一次清除率不一致,333例结石一次性清除,其余102例结石需再次经皮肾穿刺取石术或ESWL处理,但有43例拒绝再次治疗。结论:在经皮肾穿刺取石术中术者的经验和判断、肾结石的复杂性、肾穿刺部位的准确性、灌注液的外渗、肾出血等因素是影响肾结石一次清除率重要原因,应在术前应作好个性化方案;肾结石一次清除率对结石的总清除率有重要影响。
Objective: To investigate the primary clearance rate of renal stone in percutaneous nephrolithotomy and to propose corresponding countermeasures. Methods: 435 cases of patients with renal stones underwent percutaneous nephrolithotomy at different time periods, respectively, using B-or X-ray guidance, pneumatic ballistic or holmium laser lithotripsy, prone position or lateral position and other methods. Results: In different time periods, stones and methods resulted in a one-time clear rate of stones. 333 stones were removed in one go. The remaining 102 stones were treated by percutaneous nephrolithotomy or ESWL. However, 43 patients refused to be re-treated. Conclusion: The percutaneous nephrolithotripsy experience and judgment of the surgeon, the complexity of the kidney stones, the accuracy of the renal puncture site, extravasation of perfusion fluid, renal bleeding and other factors that affect the clearance rate of primary renal calculi, Should be personalized preoperative program; a clearance rate of stones on the total clearance of stones have a significant impact.