摘要
目的:探讨超声在经皮肾镜取石术中的价值与操作技巧。方法:2010年6月～2011年9月对452例肾结石、输尿管上段结石患者行经皮肾镜取石术,术中均采用超声定位穿刺建立经皮肾通道、指导寻找结石、帮助术中决策等。结果:全部患者均成功建立皮肾通道,其中1针成功421例,2针成功31例;定位穿刺耗时5～14min,平均8min;无大出血及周围脏器损伤等严重并发症发生;单通道取石396例,双通道49例,三通道7例;术中镜体可见视野内无结石后再次超声扫查发现结石残留37例,按超声提示位置再次寻找或建立通道取石,结石清除率92.0%。术后随访2～12个月,无迟发性出血、感染等并发症。结论:超声定位建立经皮肾通道具有定位准确、成功率高的优点,术中可指导寻找剩余结石,并帮助术中决定是否结束手术、再次寻找结石或建立通道,但需掌握一定的操作技巧。
Objective：To investigate the operational techniques and applicational value of ultrasound in percutaneous nephrolithotomy. Method： A total of 452 patients with renal and/or upper ureteral calculi underwent pereuta- neous nephrolithotripsy by ultrasound guidance were retrospectively analyzed. The ultrasound technology and op- erational skill in localization, guidance and decision making were retrospectively analyzed. Result： All operations were performed successfully and optimal working channels were established. The mean time of the localization was 8 minutes. No major complications as injury of pleura and abdominal organs were occurred. 396 cases were cured by one tunnel way, 49 cases by double tunnel, and 7 cases renal units by multiple tunnels. Stone-free rate was 92. 0%. No complication as bleeding and infection occurred during 2 to 12 months＇follow-up. Conclusion： The ul- trosonography is valuable for localization, guidance, observation during operation and help looking for residual stones and deciding wheter to establish other working channels or ending operation. Certain operational skill is necessary.
出处
《临床泌尿外科杂志》
2012年第7期535-536,539,共3页
Journal of Clinical Urology
关键词
输尿管结石
肾结石
超声
经皮肾镜取石术
ureteral calculi
renal calculi
ultrasonography
percutaneous nephrolithotomy
