B超引导局部麻醉PCNL在上尿路结石治疗中的应用

目的：探讨B超引导局部麻醉经皮肾镜取石术（PCNL）在上尿路结石治疗中的安全性和价值。方法：本组60例上尿路结石患者均在B超引导局部麻醉下行PCNL治疗。结果：60例均一期穿刺造瘘成功，54例一期成功行PCNL，6例患者因脓肾改行二期PCNL，总结石清除率为95.0%。手术时间为20-120 min，平均45 min，无严重并发症。结论：B超引导局部麻醉PCNL治疗上尿路结石具有创伤小、并发症少、恢复快、结石清除率高等优点，可作为肾结石或输尿管上段结石的治疗方法。

Treatment of Upper Uriny Tract Calculi with Percutaneous Nephrolithotomy under the Guidance of Ultrasound and Local Infiltration Anesthesia

Objective：To evaluate the safety and feasibility of minimally invasive percutaneous nephrolithotomy under the guide of B ultrasound and local anesthesia in treating upper uriny tract calculi.Method：60 patients with renal calculi or ureteral calculus who underwent PCNL were retrospectively analyzed. All 60 cases underwent PCNL with local infiltration anesthesia under the guidance of ultrasound. Result：Among 60 cases,54 cases were stone free after one stage PCNL,6 cases stone free after two stages PCNL for renal pyonephrosis. The total stone free rate was 95.0%. The operative duration was 45 min（20-120 min）. No severe complications were observed. Conclusion：PCNL under the guidance of ultrasound and local infiltration anesthesia offers advantages with respect to easy operation,less invasion,less complications,high stone free rate. It is a minimally invasive way in treatment of renal and ureteral calculus.