国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2012年
1期
40-43
,共4页
李九智%王晨宇%李建兴%文彬%罗勇%安尼瓦尔%王素甫%王岩岗%阿不力孜%司马义
李九智%王晨宇%李建興%文彬%囉勇%安尼瓦爾%王素甫%王巖崗%阿不力孜%司馬義
리구지%왕신우%리건흥%문빈%라용%안니와이%왕소보%왕암강%아불력자%사마의
肾结石%内窥镜检查%碎石术
腎結石%內窺鏡檢查%碎石術
신결석%내규경검사%쇄석술
Kidney Calculi%Endoscopy%Lithotripsy
目的 评价B超引导穿刺的微通道( F12F16)经皮肾镜碎石术治疗肾盏结石的安全性和有效性.方法 2009年5月2011年8月共收治ESWL无效及透X线肾盏结石44例(44侧肾结石),其中下盏结石24侧,中盏结石11侧,分支性肾盂上盏合并下盏结石9侧,结石长径(16.14±5.12)mm.采用B超引导穿刺的微通道(F12～F16)经皮肾镜碎石术,气压弹道击碎并清除结石.结果 44例均一期建立通道并碎石,其中单通道36侧肾,双通道9侧肾；经上盏建立通道9个,经中盏11个,经下盏33个.手术时间(49.3±10.9)min,一期手术结石清除率97.73％ (43/44).术后血红蛋白含量较术前下降(9.13±3.7)g/L.围手术期无输血,与手术相关的感染发生率为6.18％ (3/44),主要表现为术后发热,无气胸或腹腔脏器损伤.44例随访6～20个月,平均11.4个月,1例残余结石排出,术后6个月结石复发率为2.27％(1/44),1年结石复发率为6.18％ (3/44).结论 B超引导穿刺的微通道经皮肾镜碎石术治疗肾盏结石有效、安全,是此类结石的首选治疗方法.
目的 評價B超引導穿刺的微通道( F12F16)經皮腎鏡碎石術治療腎盞結石的安全性和有效性.方法 2009年5月2011年8月共收治ESWL無效及透X線腎盞結石44例(44側腎結石),其中下盞結石24側,中盞結石11側,分支性腎盂上盞閤併下盞結石9側,結石長徑(16.14±5.12)mm.採用B超引導穿刺的微通道(F12～F16)經皮腎鏡碎石術,氣壓彈道擊碎併清除結石.結果 44例均一期建立通道併碎石,其中單通道36側腎,雙通道9側腎；經上盞建立通道9箇,經中盞11箇,經下盞33箇.手術時間(49.3±10.9)min,一期手術結石清除率97.73％ (43/44).術後血紅蛋白含量較術前下降(9.13±3.7)g/L.圍手術期無輸血,與手術相關的感染髮生率為6.18％ (3/44),主要錶現為術後髮熱,無氣胸或腹腔髒器損傷.44例隨訪6～20箇月,平均11.4箇月,1例殘餘結石排齣,術後6箇月結石複髮率為2.27％(1/44),1年結石複髮率為6.18％ (3/44).結論 B超引導穿刺的微通道經皮腎鏡碎石術治療腎盞結石有效、安全,是此類結石的首選治療方法.
목적 평개B초인도천자적미통도( F12F16)경피신경쇄석술치료신잔결석적안전성화유효성.방법 2009년5월2011년8월공수치ESWL무효급투X선신잔결석44례(44측신결석),기중하잔결석24측,중잔결석11측,분지성신우상잔합병하잔결석9측,결석장경(16.14±5.12)mm.채용B초인도천자적미통도(F12～F16)경피신경쇄석술,기압탄도격쇄병청제결석.결과 44례균일기건립통도병쇄석,기중단통도36측신,쌍통도9측신；경상잔건립통도9개,경중잔11개,경하잔33개.수술시간(49.3±10.9)min,일기수술결석청제솔97.73％ (43/44).술후혈홍단백함량교술전하강(9.13±3.7)g/L.위수술기무수혈,여수술상관적감염발생솔위6.18％ (3/44),주요표현위술후발열,무기흉혹복강장기손상.44례수방6～20개월,평균11.4개월,1례잔여결석배출,술후6개월결석복발솔위2.27％(1/44),1년결석복발솔위6.18％ (3/44).결론 B초인도천자적미통도경피신경쇄석술치료신잔결석유효、안전,시차류결석적수선치료방법.
Objectives To evaluate the safety and therapeutic effect of mPCNL (mini - invasive percutaneous nephrostolithotripsy) of F12 to F16 in renal calyceal stones under the guidance of B - mode combined with color Doppler ultrasonography.Methods From May 2009 to August 2011,a total of 44 cases of renal calyceal stone failed in treatment with ESWL and negative stone under X ray,including 24 cases in lower pole calices,11 cases in middle calices,9 cases in lower pole calices with a tree branch like collection system.The maximum length of the stones were (16.14 ± 5.12 )mm.All procedure were under the guidance of B -mode combined with color Doppler,and the pneumatic lithotripsy were used to fragmentate the stone.Results All 44 cases were treated by one - stage PCNL,inculding single tract in 36 kidneys,dual -tract in 9 kidneys.Tracts were eastablished in 9 cases of upper pole calices,11 cases of middle calices and 33 in lower pole calices respectively.The one - stage stone free rate was 97.73％ (43/44) with the operation time of (49.3 ± 10.9 ) min.The hemoglobin declined by ( 9.13 ± 3.7 ) g/L postoperatively when compare with their preoperative counterpart.No perioperative bleeding was recording,and no transfusion was requied.Infection rate related to operation was 6.18％ (3/44),which demostrated by fever.No case experience pneumothorax or peritoneal injury.The follow up duration range from 6 to 20 months ( mean 11.4 months).Residuary stone discharge was observed in 1 case.The recurrence rate of renal stone was 2.27％ (1/44) duing 6 months of follow up,which increased to 6.18％ (3/44) after 1 year.Conclusions Using combined B - mode and color Doppler ultrasound guidance during m - PCNL resulted in safe and effective therapeutic method for calyceal calculus,and can be considered as treatment of choice for this kind of stones.
