微创经皮肾镜超声与x线定位方式的临床对比

目的比较微创经皮肾镜碎石取石术中x线与B超引导建立经皮肾通道的效果。方法对132例肾结石的患者，分别随机采用X线C臂机及B超引导建立经皮肾通道一期碎石取石治疗，其中采用x线引导组58例，B超引导组74例。结果X线引导组和B超引导组建立通道时间分别为（30．2±14．6）min和（10．6±6．2）min，手术前后血红蛋白下降值分别为（18±9）g／L和（11±5）g／L，结石残留率分别为36．2％（21／58）和44．6％（33／74），发生出血等并发症分别为8例和3例；均无死亡患者。结论虽然两种方法各有优缺点，但B超引导下经皮肾镜手术穿刺简单、成功率高、损伤小、并发症少、出血少，多通道建立简便、设备要求低，是今后经皮肾镜发展的方向。

Comparison of ultrasound and X-ray in establishing percutaneous access for minimal invasive percutaneous nephrolithotomy

Objective To compare the efficacy of establishing percutaneous access under the guidance of ultrasound and X-ray for minimal invasive percutaneous nephrolithotomy （mPCN）. Methods 58 and 74 cases of renal calculi underwent ini- tial mPCN under the guidance of X-ray and ultrasound respectively. Results In the X-ray group and the ultrasound group, the operation time was （30.2±14.6） and （10.6±6.2）min, Hb was reduced to （18±9）g/L and （11±5） g/L after the opera- tion, the rate of residual stone was 36. 2% （21/58） and 44.6% （33/74）, and 8 and 3 cases respectively developed complica- tions. Conclusion Both techniques have advantages and disadvantages. Ultrasound can easily and effectively establish the percutaneous tract and it will be widely used in mPCN