彩色多普勒超声引导经皮肾镜治疗复杂输尿管上段结石的临床价值

目的探讨彩色多普勒超声引导经皮肾镜下气压弹道碎石术治疗复杂输尿管上段结石的优势。方法复杂输尿管上段结石患者20例,结石长径1.2～2.3cm。采用彩色多普勒超声引导穿刺建立皮肾通道,气压弹道碎石,记录术中及术后出血情况、手术时间、结石清除率、术后并发症及术后住院时间。结果 21例患者均Ⅰ期建立经皮肾通道并碎石成功,结石清除率为100%,术中及术后均无明显出血,平均手术时间39min,术后平均住院时间5d,术后无严重感染病例发生,未发生气胸及肾脏周围脏器损伤等并发症。结论彩色多普勒超声引导经皮肾镜治疗复杂输尿管上段结石,具有结石清除率高、并发症少等优点。彩色多普勒超声引导除了具有普通超声引导的优势外,还可有效避开肾实质大血管损伤,减少经皮肾镜出血风险。

Percutaneous nephrolithotomy for management of complex upper ureteral calculi with color Dopplar ultrasound-guided puncture

Objectives To evaluate the role of percutaneous nephrolithotomy in management of the patients with complex upper ureteral calculi by color dopplar ultrasound-guided puncture. Methods A total of 21 patients with complex upper ureteral stones were included in the study. All the stones were located in the upper ureter renal above L4 with a stone size 1.2-2.3 cm in the largest diameter. All patients were treated by percutaneous nephrolithotomy and 21 percutaneous nephrolithotomy procedures were performed under color doppler ultrasound guidance. The success rate of bleeding volume, operation time and technique morbidity,and duration of hospitalization were recorded. Results The procedures of percutaneous nephrolithotomy in 21 cases were performed in 1 stage, the overall stone-free rate was 100%, the mean operation-time was 39 minutes, the mean duration of hospitalization was 3 days. No severe bleeding, infection and other severe complications occurred. Conclusion Percutaneous nephrolithotomy under ultrasound guidance is a safe and effective method for the treatment of patients with complex upper ureteral stones.