普通超声引导经皮肾镜取石术的效果分析

目的:探讨普通超声引导经皮肾穿刺行经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)的方法及效果.方法:利用普通超声引导经皮肾穿刺方法的改进,行PCNL 169例,对每处建立经皮肾通道的穿刺成功率、手术出血情况、术后并发症等进行回顾性分析.结果:169例患者建立经皮肾通道198处,穿刺成功率96.0%(190/198),8处术中寻找残余结石进行二次穿刺未成功,联合C-臂机穿刺成功;术后输血(200~400 mL)7例,无选择性肾动脉栓塞止血;胸腔积液18例,1例需闭式引流;术后发热11例,无感染性休克及不良预后发生;无肺脏及其他内脏损伤等严重并发症.结论:通过对普通超声引导经皮肾穿刺方法的改进,行PCNL操作简便、迅速、准确、经济,成功率高,可有效降低穿刺的难度,值得基层医院推广.

The effect analysis of the pereutaneous nephrolithotomy guided by ordinary ultrasound

Objective:To investigate the safety and clinical effects of the pereutaneous nephrolithotomy(PCNL) guided by ordinary ultrasound. Methods:One hundred and sixty patients treated with pereutaneous nephrolithotomy guided by ordinary ultrasound. The success puncture rate in percutaneous renal channel,bleeding and postoperative complications were retrospectively analyzed. Results:Total 198 channels were established in 169 cases. The success rate of puncture was 96. 0%(190/198). The second puncture operation for looking for the residual stone was not successful,but the puncture combined with C-arm X-ray was successful. Seven patients with postoperative blood transfusion for 200 mL to 400 mL were treated with non-selective renal artery embolization. The pleural effusion in 18 cases were identified, and 1 case need to be closed drainage. The postoperative fever in 11 cases, no infectious shock, no poor prognosis,and lungs and other visceral injury were found. Conclusions:The improved percutaneous renal punture guided by ordinary ultrasound in pereutaneous nephrolithotomy is simple,rapid,accurate,economic,high successful rate,which can effectively reduce the difficulty of puncture,and is worthy of promotion in primary hospitals.