摘要
目的探讨B超引导下经目标肾盏穹窿穿刺技术单通道行经皮肾取石术的安全性与疗效。方法 2012年6月‐2016年12月收治525例530侧上尿路结石,结石最大长径(27±8)mm。均在B超引导下从目标肾盏穹窿部穿刺,选择建立经皮肾单通道,采用钬激光碎石取石术。结果 525例530侧患者均穿刺成功建立单通道行经皮肾取石术,468侧行一期取石术(88.3%),40侧行二期取石术(7.5%)。穿刺时间3~25 min,平均(15±10)min。平均手术时间(60±35)min。手术中及手术后输血6例(1.1%)、术后发热9例(1.7%),无选择性肾血管栓塞止血。无血气胸、肝脾肠道损伤等严重并发症。术后1周及3个月复查腹部平片(KUB)或B超,508侧患者结石完全清除,22侧有少量结石残留(4.2%),结石总体清除率95.8%(508/530)。结论 B超引导下目标肾盏穹窿穿刺技术单通道行经皮肾取石术治疗上尿路结石安全、有效、并发症极少。
【Objective】To explore the safety and efficacy of the single-channel percutaneous nephrolithotomy with the target renal calyx puncture technique.【Methods】From June 2012 to December 2016,525 patients with urinary calculi（530 kidneys） were treated in our hospital,with the maximum length of（27 ± 8） mm.All of them were performed target renal calyx puncture guided by B ultrasound,percutaneous renal single channel was established,and holmium laser lithotripsy was adopted.【Results】Singlechannel percutaneous nephrolithotomy was successful in all patients,with 468 lateral phase I lithotomy（88.3%） and 40 lateral phase II lithotomy（7.5%）.Puncture time was 3~25 min,average（15 ± 10） min.The mean time for surgery was（60 ± 35） min.There were 6 cases（1.1%） of blood transfusions during operation and after surgery,9 cases（1.7%） of postoperative fever,and no selective renal thromboembolism.There were no serious complications such as blood chest,and hepatic,splenic or intestinal injury.One week and 3 months after surgery,kidney ureter bladder（KUB） X-ray or B ultrasound was reexamined,the stones in 508 kidneys were completely cleared,there was a small amount of stone residue（4.2%） on 22 sides,and the total clearance rate of the stones was 95.8 %（508/530）.【Conclusion】The method for the treatment of urinary calculi is safe,effective with few complications.
出处
《中国医学工程》
2017年第8期12-15,共4页
China Medical Engineering
基金
娄底市中心医院院级青年课题(Y201629)
关键词
B超定位
目标肾盏
经皮肾镜取石术
钬激光碎石术
B ultrasound localization
target renal pelvis
percutaneous nephrolithotomy
holmium laser lithotripsy
