【摘要】 目的 比较点触式探针和平面探针在肾铸型结石经皮肾镜超声碎石清石术中的安全性和优越性。方法 62例肾铸型结石患者随机分为观察组32例、对照组30例，分别用点触式探针和平面探针行经皮肾镜超声碎石清石术。探针难以击碎的坚硬结石，辅助气压弹道碎石，再行超声碎石清石。术后采取视频回放法，准确记录碎石清石所用时间，同时观察两种探针对尿路黏膜的的损伤情况。术后采取排水法，测量每例结石的体积，分别计算每例碎石清石速度。结果 观察组仅用点触式探针顺利完成手术，对照组8例需借助气压弹道碎石后再用平面探针超声碎石清石。观察组碎石清石速度是对照组的2.3倍(P<0.05),碎石清石时间仅为对照组的1/2。观察组未出现尿路黏膜损伤，对照组出现多例轻微尿路黏膜吸附伤，但无需处理。结论 在铸型结石经皮肾镜超声碎石清石术中运用点触式探针较平面探针碎石速度快、效率高、安全性好。更多还原

【Abstract】 Objective To compare of the safety and effectiveness of point contact probes and plane probes in percutaneous nephrolithotomy for treatment of staghorn renal calculi. Methods A total of 62 patients with staghorn renal calculi were randomly divided into two groups: a point contact probe group(an observation group, n=32) and a plane probe group(a control group, n=30). All patients underwent percutaneous nephrolithotomy using corresponding probes. For kidney stones that were difficult to be broken down by ultrasonic probes, pneumatic lithotripsy was adopted before ultrasonic lithotripsy. After surgery, videos were played back to record the time of lithotripsy, while the damage of the mucous membrane of the urinary tract caused by the two probes was also observed. The volume of each stone was measured by the drainage method to calculate the rate of lithotripsy. Results Surgeries were successfully finished for patients in the observation group using point contact probes alone. The control group had eight patients who required pneumatic lithotripsy before ultrasonic lithotripsy using plane probes. The observation group showed a rate of lithotripsy which was 2.6 times higher than that of the control group(P<0.05), requiring a period of time that was only 1/2 of the control. No injury was found in the mucous membrane of the urinary tract, in comparison with slight mucosal injury of the urinary in the control group which however needed to deal with. Conclusion Point contact probes can be applied in percutaneous nephrolithotomy for treatment of staghorn renal calculi, which is fast, efficient and safe.更多还原