Research on the curative effect of standard channel PCNL combined with ultrasonic pneumatic lithotripsy in the treatment of upper urinary tract calculi under the guidance of ultrasound / 中国医学装备

ABSTRACT

Objective:To study the curative effect of standard channel (percutaneous nephrolithotomy) PCNL combined with ultrasonic pneumatic lithotripsy in the treatment of upper urinary tract calculi under the guidance of ultrasound, and analyze the influence factors of post-operative residual calculi.Methods: The data of 94 patients with upper urinary tract calculi were researched by using retrospective analysis. All of patients underwent the treatment of standard channel PCNL combined with ultrasonic pneumatic lithotripsy for upper urinary tract calculi under the guidance of ultrasound. The curative effects of upper ureteral calculi, pelvis calculi, multiple renal calculi, kidney stone with ureteral calculi and renal staghorn calculi were observed, and the post-operative complications were further detected so as to grasp the situation of residual calculi and calculate the clearance rate of calculus. The difference of general documents between patients with residual calculi and those without residual calculi were compared, and the influence factors of residual calculi were analyzed by using Logistic regression equation.Results:The incidence of post-operative complication was 27.66%, the clearance rate of calculus was 67.2% and residual rate of calculus was 32.98%. The differences of location puncture time, establishing channel time and ostomy fistula time among the five kinds of patients were no significant (F=1.89,F=2.46, F=0.91,P>0.05). While the differences of calculus removed time, amount of bleeding in intra-operative period and length of stay among various kinds of patients were significant (F=81.90,F=35.84,F=4.17,P<0.05). Depended on the results of Logistic regression equation, the types of calculus, size of calculus, hydronephrosis, urinary tract infection and renal insufficiency were the influence factors of post-operative residual calculus of patients with upper urinary tract calculi who received the treatment of PCNL combined with ultrasonic pneumatic lithotripsy.Conclusion: PCNL combined with ultrasound pneumatic lithotripsy under the guidance of B ultrasound without major complications has better curative effect, and its clearance rate of calculus is higher. Besides, the types of calculus, size of calculus, hydronephrosis, urinary tract infection and renal insufficiency can increase the incidence of post-operative residual calculus and affect the curative effect.