论文部分内容阅读
目的:探讨B超引导下超声联合弹道EMSⅢ代治疗复杂性肾结石的方法及疗效。方法:回顾性分析2008年11月～2011年6月收治180例复杂性肾结石患者的临床资料,包括单发肾盂或肾盏结石25例,多发性结石135例,肾鹿角形或铸型结石20例;其中双肾结石35例,结石合并脓肾3例。B超引导下穿刺并扩张建立F24经皮肾镜操作通道,采用超声联合气压弹道碎石清石。结石合并脓肾患者先用超声吸附装置清理脓液和脓栓,并在低压下超声碎石后吸出脓液,再行碎石清石术。结果:所有病例均一次穿刺成功。8例鹿角形巨大结石行双通道取石,余均为单通道取石,全部一期完成手术。手术时间50～120min,平均70min。术中出血量50～300ml,平均120ml。结石一次性取净率91.1%(164/180),残留小结石16例,结石直径<0.7cm,术后1个月行ESWL治疗,结石完全排净。术中术后未发生严重并发症。结论:B超引导下经皮肾镜超声联合弹道碎石清石治疗复杂性肾结石安全、高效,是临床微创治疗复杂性肾结石的理想选择。
Objective: To investigate the method and efficacy of ultrasonography combined with ballistic progeny EMS Ⅲ generation for complex renal calculus under B-guided ultrasound. Methods: The clinical data of 180 patients with complex renal calculus from November 2008 to June 2011 were retrospectively analyzed. Among them, 25 cases were single pelvis or calyx calculi, 135 cases were multiple stones, kidney antlers or cast stones 20 cases; of which 35 cases of kidney stones, stones with pus kidney in 3 cases. B-guided ultrasonography and expansion of the establishment of F24 percutaneous nephrolithotomy channel, the use of ultrasound combined with pneumatic lithotripsy stone. Patients with stones and pus kidney should first be cleaned of pus and pus suppository with an ultrasonic adsorption device, and pus should be aspirated after the ultrasonic lithotripsy under low pressure, followed by lithotripsy. Results: All cases were successfully punctured. Eight cases of antlers huge stone line double channel stone, I were more than a single channel stone, all the first phase of surgery. Surgery time 50 ~ 120min, an average of 70min. Intraoperative bleeding 50 ~ 300ml, an average of 120ml. The one-time extraction rate of stones was 91.1% (164/180). There were 16 small residual stones and the diameter of stones was less than 0.7cm. ESWL treatment was performed one month after the operation and stones were completely drained. No serious postoperative complications occurred. Conclusion: B ultrasound-guided percutaneous nephroscope combined with lithotripsy lithotripsy is safe and effective in treating complex renal calculi. It is an ideal choice for clinical minimally invasive treatment of complex renal calculi.