联合B超和C臂双重定位引导经皮肾穿刺在上尿路结石治疗中的应用

目的:探讨联合B超和C臂双重定位引导经皮肾穿刺建立工作通道在上尿路结石治疗中的应用价值。方法:选择204例上尿路结石拟行PCNL治疗的患者,术中联合B超和C臂双重定位引导经皮肾穿刺,分别建立1～4个工作通道,同期或分期进行碎石清石处理。结果:204例患者共建立经皮肾穿刺工作通道271个,均为一期完成。其中每侧肾脏单通道199个,2个通道57个,3个通道11个,4个通道4个。总净石率91%。无一例并发肠道、肝、脾、肺及腔静脉等器官损伤。胸腔积液6例,均保守处理治愈;气胸2例,行抽气处理治愈。无术后因大出血需动脉栓塞治疗患者,无中转开放手术患者。结论:联合B超和C臂双重定位引导经皮肾穿刺可提高穿刺的准确性和成功率,增加安全性,减少并发症的发生。

Combined ultrasound and X-ray guidance for percutaneous renal access in the treatment of upper urinary calculi(Report of 204 cases)

Objective:To investigate the technique of guidance combined ultrasound and X-ray for percutaneous renal access in the treatment of upper urinary calculi.Methods:204 patients with upper urinary calculus were underwent PCNL under the guidance of ultrasound and X-ray.Results:271 tracts were successfully established in the first stage of operation,PCNL were finished in 190 patients in the stage I lithotripsy.The clearance rates were 91%.There are less complications.None renal arteriolar embolization was needed.Conclusions:It is safe and effective in the guidance for percutaneous renal access combined ultrasound and X-ray in the treatment of upper urinary caculi.