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目的评价超声介导经皮肾镜下气压弹道联合超声碎石术治疗鹿角形肾结石的临床疗效。方法回顾性分析本院2006-09~2009-07间,应用超声引导经皮肾镜气压弹道联合超声碎石治疗600例鹿角形结石患者的临床资料,对其治疗方法、临床疗效及其优点等资料进行评价。结果600例均Ⅰ期成功建立经皮肾通道,双通道取石456例。手术时间82~180 min,术中失血40~800 mL,Ⅰ期手术结石取尽率为70.3%(422/600);手术总的结石取尽率88.8%(533/600),肾盂梗阻解除率100%。本组有428例随访1~6个月,无严重出血、感染及患肾功能丧失,亦无肾周积液、结石复发。结论超声介导下经皮肾镜超声联合气压弹道碎石清石术治疗鹿角形肾结石可明显提高碎石、清石率,缩短手术时间,减少并发症,值得临床推广应用。
Objective To evaluate the clinical effect of ultrasonic guided percutaneous nephrolithotomy combined with ultrasonic lithotripsy in the treatment of antler kidney stones. Methods The clinical data of 600 cases of antlers treated with ultrasound guided percutaneous nephrolithotomy combined with ultrasonic lithotripsy in our hospital from September 2006 to July 2009 were retrospectively analyzed. The treatment, clinical efficacy and advantages Data evaluation. Results All 600 cases were successfully established percutaneous renal access, 456 cases of double-channel stone. The operative time ranged from 82 to 180 minutes, and the intraoperative blood loss was 40 to 800 mL. The complete recovery rate of stage Ⅰ surgical stone was 70.3% (422/600). The total operation stone removal rate was 88.8% (533/600) 100%. This group of 428 cases were followed up for 1 to 6 months, no severe bleeding, infection and renal dysfunction, no renal fluid, stones recurrence. Conclusion Ultrasound-guided percutaneous nephrolithotomy combined with pneumatic lithotripsy lithotripsy staghorn kidney stones can significantly improve the gravel, clear stone rate, shorten the operation time and reduce complications, worthy of clinical application.