Clinical analysis of two kinds of probe ultrasonic lithotripsy in the treatment of complicated upper urinary calculi

doi:10.3877/cma.j.issn.1674-3253.2020.04.004

Abstract

Abstract:

Objective

To evaluate the efficacy and advantages of point touch probe percutaneous ultrasonic nephrolithotomy in the treatment of complicated upper urinary calculi.

Method

The clinical data of patients with complicated upper urinary calculi undergoing percutaneous ultrasonic nephrolithotomy were analyzed retrospectively. Both the point contact probe group and the original plane probe group had 43 cases. The lithotripsy efficiency of the two probes, the stone removal rate and the complications of urinary tract mucosal injury and serious sepsis were observed.

Results

The stone removal time and speed of point contact probe were significantly better than that of plane probe (P<0.01), the stone removal efficiency was increased to 2.74 times, and the stone removal rate was significantly different from that of the original plane probe group (P<0.05). In the original plane probe group, there were 9 cases of urinary tract mucosal injury and 2 cases of severe sepsis. In the observation group, there was no urinary tract mucosal injury in operation or severe sepsis after operation. The difference between the two groups were all significant (P<0.01).

Conclusion

The point contact probe percutaneous ultrasonic nephrolithotomy is efficient and safe. It is the preferred method for the treatment of complicated upper urinary calculi and is worthy of clinical application.

Key words: Complex upper urinary calculi, PCNL, Ultrasound probe, Point touch probe

Heng Wang, Junqi Wang, Yongbin Huang, Haitao Zhang, Zhaofei Liu, Pengfei Mao, Ruizhi Nie, Xiangjun Xu. Clinical analysis of two kinds of probe ultrasonic lithotripsy in the treatment of complicated upper urinary calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(04): 254-257.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2020.04.004

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2020/V14/I04/254

Figures/Tables 5

References 15

[1]	吴阶平. 吴阶平泌尿外科学[M]. 济南: 山东科学技术出版社, 2004: 811.
[2]	李逊. 经皮肾镜取石术的微创理念[J/CD]. 中华腔镜泌尿外科杂志（电子版）, 2010, 4(3):1 76-179.
[3]	万银绪, 车吉忠, 张永富, 等. 经皮肾镜联合软性膀胱镜治疗复杂性肾结石的临床分析[J]. 中华泌尿外科杂志, 2014, 35(8): 579-582.
[4]	王珩, 孙晓青, 王军起, 等. 经皮肾镜超声碎石清石术两种不同探针治疗肾铸型结石比较研究[J]. 徐州医学院学报, 2016, 36(5): 321-324.
[5]	徐向军, 张海涛, 刘兆飞, 等. 两种探针超声碎石治疗老年上尿路结石患者的临床观察[J].实用医学杂志, 2016, 32(9): 1491-1493.
[6]	杨丽芬. 输尿管镜气压弹道碎石联合体外冲击波碎石治疗复杂性上尿路结石[J]. 牡丹江医学院学报, 2019, 40(4): 70-71.
[7]	陈宏宇, 韩毅, 胡国栋, 等. 肾镜联合输尿管软镜通过经皮肾单通道取石治疗肾鹿角形结石[J/CD]. 中华腔镜泌尿外科杂志（电子版）, 2019, 13(1): 28-31.
[8]	盛战宇, 汪志民, 唐智旺. 单通道经皮肾镜取石联合胆道镜钬激光碎石术治疗复杂性上尿路结石的初步体会[J]. 中国内镜杂志, 2016, 22(10): 100-102.
[9]	何灼彬, 黄安余, 卢凤英. 硕通镜联合输尿管软镜与经皮肾镜联合输尿管软镜治疗复杂性肾结石的临床比较观察[J]. 山西医药杂志, 2018, 47(16): 1923-1927.
[10]	黄苏溪, 袁超英, 袁杰, 等. 多镜联合治疗复杂性上尿路结石[J].中国内镜杂志, 2016, 22(4): 100-103.
[11]	黄永斌, 聂锐志, 张海涛, 等. 点触式探针提高超声碎石效率的研究[J]. 中华实验外科杂志, 2015, 32(10): 2568-2568.
[12]	范治璐, 冷德臣, 刘志宇, 等. 肾内肾盂为肾内铸型结石形成的重要原因(附37例报告)[J]. 大连医科大学学报, 2001, 23(3): 189-190,192.
[13]	黄永斌, 王军起, 刘成, 等. 点触式探针在铸型结石超声碎石术中的应用探讨[J]. 中国内镜杂志, 2015, 21(8): 890-892.
[14]	Akman T, Binbay M, Sari E, et a1. Factors affecting bleeding during percutaneous nephrolithotomy:single surgeon experience[J].J Endourol, 2011, 25(2): 327-333
[15]	段波, 陈斌, 黄海超, 等. 针道法辅助标准经皮肾镜取石术治疗复杂性上尿路结石的临床研究[J]. 中华外科杂志, 2018, 56(10): 768-771.

组别	例数	性别(例)		年龄（岁，±s）	例数
组别	例数	男	女	年龄（岁，±s）	鹿角状结石	多发性肾结石	感染性结石	孤立性肾结石	肾下垂肾结石	输尿管上段结石(半肾结石)	合并肾积水	合并感染	肾功能不全
点触式探针组	43	31	12	46±11	12	15	6	1	1	8	22	11	2
原平面探针组	43	32	11	47±13	13	13	6	1	1	9	22	10	1
统计值	?	χ²=0.059		t=-0.537	χ²=15.078	χ²=10.488	-	-	-	χ²=0.073	-	χ²=0.063	-
P值	?	1		-0.594	<0.001	<0.001	1	1	1	0.787	1	0.802	0.557

组别	例数	性别(例)		年龄（岁，±s）	例数
组别	例数	男	女	年龄（岁，±s）	鹿角状结石	多发性肾结石	感染性结石	孤立性肾结石	肾下垂肾结石	输尿管上段结石(半肾结石)	合并肾积水	合并感染	肾功能不全
点触式探针组	43	31	12	46±11	12	15	6	1	1	8	22	11	2
原平面探针组	43	32	11	47±13	13	13	6	1	1	9	22	10	1
统计值	?	χ²=0.059		t=-0.537	χ²=15.078	χ²=10.488	-	-	-	χ²=0.073	-	χ²=0.063	-
P值	?	1		-0.594	<0.001	<0.001	1	1	1	0.787	1	0.802	0.557

组别	例数	一水草酸钙	草酸钙与碳酸磷灰石	尿酸结石	六水磷酸铵镁
点触式探针组	43	11	22	4	6
平面探针组	43	10	21	5	7
χ²值	?	0.063	0.047	0.124	0.091
P值	?	0.082	0.829	0.725	0.763

组别	例数	一水草酸钙	草酸钙与碳酸磷灰石	尿酸结石	六水磷酸铵镁
点触式探针组	43	11	22	4	6
平面探针组	43	10	21	5	7
χ²值	?	0.063	0.047	0.124	0.091
P值	?	0.082	0.829	0.725	0.763

组别	例数	清石体积（ml，±s）	时间（min，±s）	速度（ml/min，±s）	清石率[例（%）]	吸附伤发生率[例（%）]	严重感染发生率[例（%）]
点触式探针组	43	9.1±2.2	15.2±5.3	0.85±0.25	42（97.67）	0（0）	0（0）
原探针组	43	9.3±2.4	27.3±7.5	0.31±0.15	37（86.05）	9（20.93）	2（4.65）
统计值	?	t=0.372	t=-6.072	t=5.318	χ²=3.888	χ²=10.052	-
P值	?	0.712	<0.001	<0.001	0.049	<0.001	0.152

Please choose a citation manager

Content to export