B超引导下经皮肾镜超声联合气压弹道碎石清石术的临床观察

目的探讨复杂上尿路结石碎石治疗中B型超声引导下经皮肾镜超声碎石联合气压弹道碎石的临床效果。方法选取笔者所在医院2008年1月～2010年12月泌尿外科收治的复杂上尿路结石患者106例,行B型超声引导下经皮肾镜超声碎石联合气压弹道碎石术进行治疗,另选取体外震波碎石治疗的患者100例作为对照组(109侧)。结果本组患者单侧平均手术时间(61.2±10.7)min;术中平均出血量为(70.3±9.2)mL;术后平均住院时间(6.5±2.3)d。一期手术清石率为90.27%(102/113),总清除率为96.46%(109/113)。研究组单侧手术时间与对照组相比明显缩短(P<0.05),两组住院时间与术中出血量无显著差异(P>0.05),研究组结石清除率显著高于对照组(P<0.05)。结论 B型超声引导下经皮肾镜超声碎石联合气压弹道碎石治疗复杂上尿路结石具有清石率高、并发症少的优势,适合临床推广使用。

Clinical observation of B ultrasound-guided percutaneous nephroscopic ultrasound combined with air pressure ballistic lithotripsy

Objective To investigate the clinical effects of B ultrasound-guided percutaneous nephroscopic ultrasound combined with air pressure ballistic lithotripsy in the lithotriptic treatment of complex upper urinary tract calculi.Methods One hundred and six patients with complex upper urinary tract calculi admitted to and treated in the urological department of our hospital from January 2008 to December 2010 who received B ultrasound-guided percutaneous nephroscopic ultrasound combined with air pressure ballistic lithotripsy were selected.One hundred patients with 109 cases of calculi who received extracorporeal shock wave lithotripsy were selected as the control group.Results In the study group,the mean unilateral operation time was(61.2±10.7) minutes,the mean intraoperative blood loss was(70.3±9.2)mL,and the mean postoperative hospital stay was(6.5±2.3)days.The clearance rate of one-stage operation was 90.27%(102/113) and the total clearance rate was 96.46%(109/113).The study group was significantly shorter than the control group in the unilateral operation time(P<0.05).The two groups were not significantly different in the hospital stay and the intraoperative blood loss(P>0.05).The study group was significantly higher than the control group in the calculi clearance rate(P<0.05).Conclusion B ultrasound-guided percutaneous nephroscopic ultrasound combined with air pressure ballistic lithotripsy has the advantages of high calculi clearance rate and few complications in the treatment of complex upper urinary tract calculi,thereby suitable for clinical promotion and application.