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无穿刺架超声定位引导经皮肾取石术

Mini-percutaneous nephrolithotomy by ordinary black and white B-ultrasound without puncture trestle
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摘要 目的探讨无穿刺架超声定位引导经皮肾取石术治疗肾结石的临床应用价值。方法总结我院采用无穿刺架超声定位引导经皮肾取石术治疗324例肾及输尿管上段结石的临床资料。其中复杂性肾结石232例,结石位于左侧147例,右侧126例,双侧51例。轻度肾积水131例,中度肾积水179例,重度肾积水65例,最大肾结石10.2cm×5.3cm。肾结石合并输尿管结石201例,总肾功能不全52例。结果所有病例均手术成功,平均手术时间175±25min(45~210),平均经皮肾通道建立时间16.5±5.4min。一期碎石成功244例(75.3%),需二期碎石取石80例(24.7%),多通道手术42例(13.0%),其余为单通道。结石完全清除率89.8%(291/324),发生严重出血3例(0.9%),2例输血400ml。术后发热38例(11.7%)。结论无穿刺架超声定位引导建立经皮肾通道技术可行,安全准确,也可作为经皮肾取石术的引导穿刺方法。 Objective To evaluate the treatment experience of kidney calculus guided by ordinary black and white B-ultrasound without puncture trestle in mini-percutaneous nephrolithotomy. Methods A total of 324 patients with renal or upper ureteral calculi underwent PCNL under guidance of ultrasound without puncture trestle. 232 patients had multiple calculi. The calculi were located in the left kidney in 147 cases, the fight kidney in 126 cases and both sides in 51 cases. Mild hydronephrosis was found in 131 kidneys, moderate hydronephrosis was found in 179 kidneys and severe hydronephrosis was found in 65 kidneys.The maximal calculus diameter was 10.2 cmx 5.3 cm. 201 patients had calculi in kidney and the upper ureter. 52 patients had kidney funcion failure. Results The successful operation rate was 100%. Operation time ranged from 45-210 rain, average time was 175±25 rain. The average time of establishing the percntaneous renal access was 16.5+5.4 rain. 244 cases (75.3%) were treated with one-staged opera- tion, and 80 cases (24.7%) with two-stages operation, 42 cases (13.0%)with multiple passages, the others with single passage. 3 cases(O.9%)with severe hemorrhage or bowel trauma, 2 cases required blood transfu- sion 400 ml, 38 cases(ll.7%) with postoperation fever. Conclusion It is safe, accuracy, convenience and effective for percutaneous puncture guided by ordinary black and white B-ultrasound, and it can be used for mini-percutaneous nepohrolithotomy.
出处 《中华腔镜泌尿外科杂志(电子版)》 2011年第3期18-20,共3页 Chinese Journal of Endourology(Electronic Edition)
关键词 超声检查 经皮肾穿刺 结石 Uhrasonography Percutaneous renal puncture Stone
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