Objective To explore the efficacy and skill of ultrasonography - guided percutaneous nephrolithotomy with dual probe ultrasonic lithotriptor in the treatment of renal staghorn calculi. Methods Clinical data of 27 cases including one case with cavitas pelvisectopic kidney staghorn calculi treated hy ultrasonography - guided percutaneous nephrolithotomy with dual probe ultrasonic lithotriptor from July 2009 to April 2010 were analyzed retrospectively. Results The percutaneous renal accesses were successfully established under ultrasound guidance and phase one operation was performed in all patients. The operative duration was 40 ～ 100 minutes, averaged 68 minutes. The intraoperative hlood loss was 30 ～ 150 ml, averaged 72 ml. 23 cases were discharged completely in first phase operation and the stone clearance rate was 85. 2％ . 3 cases were treated by ESWL due to residual stones and the residual stones were discharged completely. One case with big residual stones due to hemorrhage was performed second operation. The length of hospitalization was 9 ～ 12 days, averaged 10 days. No severe complications such as delayed hemorrhage and severe infection were found during 1 to 9 months' follow - up. Conclusion Ultrasonography - guided percutaneous nephrolithotomy with dual probe ultrasonic lithotriptor in treatment of upper urinary tract calculi has the advantages of high efficacy, short operative duration, little blood loss and few complications. Estahlishment of Percutaneous renal accesses is very important and attention should be paid in operational skills.%目的 探讨B超引导下经皮肾镜Cyberwand双导管超声碎石清石系统治疗肾铸型结石的疗效及技巧.方法 回顾性分析2009年7月-2010年4月27例在B超引导下应用经皮肾镜Cyberwand双导管超声碎石清石系统治疗肾铸型结石患者的临床资料,其中1例为盆腔异位肾铸型结石.结果 27例均成功建立F24皮肾通道,Ⅰ期完成手术.手术时间40～100 min,平均68 min.术中出血量30～150 ml,平均72 ml.一次完全取净结石23例,清石率为85.2%;残留结石4例,其中残余小结石2例,泥沙样结石1例,行体外冲击波碎石治疗后结石排净,1例因术中出血视野模糊导致残余结石较大(直径＞2 cm),行二次手术结石取净.住院时间9～12 d,平均10 d.随访1～9个月,均无迟发性出血、严重感染等并发症.结论 B超引导下经皮肾镜Cyberwand双导管超声碎石清石系统治疗肾铸型结石,具有结石清除率高、手术时间短、出血少、并发症少等优点,成功建立通道是手术成功的关键,碎石及清石过程中要注意一定技巧.
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