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目的探讨微创经皮肾镜下气压弹道碎石取石术治疗上尿路结石的疗效及安全性。方法回顾性分析258例微创经皮肾镜下气压弹道碎石术治疗上尿路结石的临床资料,分析围手术期数据,评估手术疗效。结果 258例手术中单通道取石251例,双通道取石7例;一期穿刺取石成功196例,二期取石成功29例,三期取石成功4例,结石总清除率88.8%。留置造瘘管者平均6.8d拔管,平均住院时间12.5d。未置造瘘管者28例,该无管化患者平均住院时间9d。无胸膜、肝脏和肠管等损伤及中转开放手术发生。结论微创经皮肾镜下气压弹道碎石取石术治疗上尿路结石具有微创、安全、出血少、结石清除率高等优点,是治疗上尿路结石的理想方法。无管化能减轻痛苦、加快恢复、缩短住院时间。
Objective To investigate the efficacy and safety of pneumatic lithotripsy with minimally invasive percutaneous nephrolithotomy in the treatment of upper urinary tract calculi. Methods A retrospective analysis of 258 cases of minimally invasive percutaneous nephrolithotomy pneumatic lithotripsy in the treatment of upper urinary tract stones clinical data, analysis of perioperative data to assess the efficacy of surgery. Results Among the 258 cases, 251 cases were single-channel stone and 7 cases were double-channel stone. The first-stage puncture was performed successfully in 196 cases, the second stage was performed successfully in 29 cases, the third stage was performed successfully in 4 cases, and the total stone removal rate was 88.8%. Indwelling fistulae averaged 6.8d extubation, the average length of stay 12.5d. 28 cases without fistula, the average length of stay of the tubeless patients 9d. No pleural, liver and intestinal damage and transit open surgery occurred. Conclusion The minimally invasive percutaneous nephrolithotomy with pneumatic lithotripsy for the treatment of upper urinary tract stones has the advantages of minimally invasive, safe, less bleeding, high rate of stone clearance and is an ideal method for the treatment of upper urinary tract calculi. Inhalation can reduce pain, speed recovery and shorten hospital stay.