介入性超声在经皮肾镜取石术前造瘘中的临床应用

目的探讨超声引导下的经皮肾穿刺造瘘术在经皮肾镜取石(PCNL)术前的临床应用价值.方法对20例多发肾结石患者及1例输尿管上段结石患者进行了PCNL术前造瘘,周后通过此通道行PCNL术.结果超声可清晰显示穿刺通路组织结构,彩超引导可有效避开血管丰富区域,显示穿刺针穿刺过程及针尖到达部位,精确测量通道扩张深度及置管深度;本组病例穿刺一次成功率100%,均置管成功.所有患者均通过此单一通道取石,0例成功取尽结石,例为肾盏畸形,多个盏颈狭窄并结石,盏内结石取出,盏外取石失败.未发生大出血病例,早期手术扩张、置管时少许出血2例,后期病例置管后引流管内尿液未见明显肉眼血尿.结论介入性超声对PCNL术有重要的临床应用价值.

Clinical Application of Interventional Ultrasound Technique to the Preoperative Treatment for Percutaneous Nephrolithotomy

Objective To investigate the clinical application of interventional ultrasound technique to the preoperative treatment for percutaneous nephrolithotomy(PCNL).Methods A total of 21 cases with renal calculi in this group underwent PCNL.Percutaneous micronephrostomy guided by B ultrasound was performed preoperatirely.PCNL were carried out through the nephrostomic tubing.Results The needle point and the process of puncturing were observed on sonography.The needle point and its pathway were demonstrated clearly and definitely on sonograms,so that vascular trauma by the needle point would be avoided.On the other hand,the depths of tubing and pathway dilation could be measured precisely.In this group,all cases were punctured successfully only one procedure,and all the total calculi were removed out only through one passage.A little blood in renal calices wound be found initially.No more blood was found later on.Conclusions Interventional ultrasound is of great value for PCNL.