Li Jian-xing, Tian Xi-quan, Niu Yi-nong, Zhang Xin, Kang Ning
Department of Urology, Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
Zhonghua Wai Ke Za Zhi. 2006 Mar 15;44(6):386-8.
To evaluate the efficacy and safety of management of renal stone in non-dilated collecting system by percutaneous nephrolithotripsy (PCNL) under ultrasound guidance.
From September 2003 to April 2005, 132 cases of renal stone in non-dilated collecting system were performed by percutaneous nephrolithotripsy. A stent was first inserted into the pelvis through cystoscope, and saline was instilled to dilate collecting system. Antegrade percutaneous access was obtained by B-type ultrasound guidance. A combination pneumatic and ultrasonic lithotrite were used to disintegrate and remove stone under direct vision. Clinical data including operation time, complications and stone free rate were analyzed retrospectively.
The percutaneous renal access was successfully established under B-type ultrasound guidance in all patients, immediate phase I lithotripsy was performed in 129 cases and delayed phase II lithotripsy in 3 cases. Operation time ranged from 70 to 130 minutes, average time was (89 +/- 11) minutes, 3 cases were supported by blood transfusion, severe complications did not occur during nephrolithotripsy. Stones were cleared in 114 out of 132 cases (86.4%) during immediate phase I lithotripsy, residual stone fragment was found in 18 cases who received second PCNL or adjuvant extracorporeal shock wave lithotripsy.
The management of renal stone in non-dilated collecting system using PCNL appears to be efficacious and safe under B-type ultrasound guidance.
评估超声引导下经皮肾镜碎石术（PCNL）治疗非扩张性集合系统肾结石的疗效及安全性。
2003年9月至2005年4月，对132例非扩张性集合系统肾结石患者行PCNL治疗。首先经膀胱镜在肾盂置入支架，注入生理盐水扩张集合系统。在B型超声引导下建立顺行经皮肾穿刺通道。直视下联合应用气压弹道超声碎石清石系统碎石取石。回顾性分析手术时间、并发症及结石清除率等临床资料。
所有患者均在B型超声引导下成功建立经皮肾穿刺通道，129例行一期碎石，3例行二期延迟碎石。手术时间70～130分钟，平均（89±11）分钟，3例输血支持，碎石过程中无严重并发症发生。一期碎石132例中114例（86.4%）结石清除，18例残留结石行二期PCNL或辅助体外冲击波碎石。
B型超声引导下PCNL治疗非扩张性集合系统肾结石安全、有效。
