GPS导航超声系统实时定位穿刺PCNL处理复杂肾结石22例报告

目的：探讨GPS导航超声系统（SonixGPS）引导定位穿刺在经皮肾取石术（PCNL）中的优势及安全性。方法：2012年5月～2012年9月，我们应用SonixGPS行经皮肾穿刺，建立Ft。皮肾通道进行取石处理复杂肾结石22例，其中男17例，女5例，年龄46～70岁，平均51．2岁。重复。肾畸形合并结石1例，肾多发结石16例，铸型肾结石2例，输尿管上段结石并肾结石3例。全部患者采用全身麻醉，用预先消毒好的超声探头在11肋间或12肋缘下区域扫查，了解结石的分布、位置、大小及和集合系统的关系情况，确定穿刺径路，皮肾通道建立成功后全部应用钬激光进行碎石。结果：借助SonixGPS穿刺，22例患者全部一次成功。除1例多发结石因残余结石行二期PCNL外，其余21例患者均一期取石成功，无一例出现术中或术后严重并发症。结论：SonixGPS可以实时追踪并显示穿刺针的方向和深度，特别对于经皮肾穿刺取石手术初学者，可以帮助清楚显示穿刺针位置，提高穿刺成功率，缩短学习曲线，可为PCNI。超声定位穿刺提供一种新的选择。

Real-time ultrasound-guided puncture by Sonix GPS navigation in PCNL with complex kidney stones （Report of 22 cases）

Objective.. To evaluate the efficacy and safety of real-time ultrasound-guided puncture by Sonix GPS navigation in percutaneous nephrolithotomy （PCNL） with complex kidney stones. Methods： From May 2012 to September 2012, 22 patients with upper urinary tract calculi were treated with PCNL under real-time ultrasound- guided puncture by Sonix GPS navigation. Among them were 17 males and five females aged 46-70 （average 51.2） years. Upper ureteral calculi combined with renal calculi were seen in three cases, while one case suffered from du- plex kidney combined with renal stones. Moreover sixteen cases were observed multiple renal calculi. At last stag- horn calculi were found in two cases. General anesthesia was used in all patients. Ultrasound scanning was per- formed with probe under the rib 11 or 12 costal margin area before PCNL in order to determine the puncture path and clearly know the distribution, position, size and its relationship with collecting system. Then holmium laser lithotripsy could be taken in all patients after procedure channel was established successfully. Results： Except for one case of multiple stones needed two-stage PCNL for residual stones, the rest of 21 patients underwent PCNL successfully by Sonix GPS navigation without any intraoperative or postoperative complications. Conclusions：Sonix GPS navigation can be real-time tracking and shows the direction and depth of the needle, especially for the begin- ners. It can also help clearly display needle position, improve the success rate of puncture, shorten the learning curve. Thus it may provide a new choice for PCNL.