CT联合超声引导微创经皮肾镜碎石取石术治疗肾输尿管上段阴性结石

目的总结CT联合超声引导微创经皮肾镜碎石取石术治疗肾输尿管上段阴性结石的经验。方法收治肾输尿管上段阴性结石患者30例，术前常规行超声、静脉肾盂造影和双肾CT平扫检查，重建CT三维成像以设计经皮肾穿刺通道。术中采用超声引导经皮肾穿刺造瘘碎石取石术。结果30例手术均获成功，无中转开放手术。手术时间45—120min，术中平均出血约100ml，无一例出现大出血、肾盂穿孔和邻近脏器损伤等严重并发症，术后5d拔除肾造瘘管，平均住院天数9d。术后复查超声，一期结石取净率达100％。结论术前行。肾脏CT三维成像以设计经皮。肾穿刺通道联合术中实时超声引导经皮肾镜碎石取石是治疗肾输尿管上段阴性结石的有效方法。

Minimally invasive percutaneous nephrolithotomy under the B-type ultrasound and CT guidance for treatment of upper urethral non-opaque calculi

Objective To summarize the experience of minimally invasive percutaneous nephrolithotomy under the B-type ultrasound and CT guidance for treatment of upper urethral non-opaque calculi. Methods 30 cases of upper urethral non-opaque calculi received B-type ultrasound , CT scan and intravenous pyelography preoperatively. The percutanous access was established during the operation under the direction of B-ultrasound. Results All the operations were successful and none transferred to open procedure. The time of the operation was 45-120 min, the mean blood lose is 100 ml approximately. no massive hemorrhage, perforation of the renal pelvis, adjacent organ injury and other severe complications occurred postoperatively . The nephrostomy tube was removed in the 5 days. The mean hospitalization time was 9 days. Stone clearance is 100%. Conclusion Protocol the percutanous access under kidney CT scan before the operation and establish the access under the direction of B-ultrasound during the operation is useful for the minimally invasive percutaneous nephrolithotomy in the treatment of upper urethral non-opaque calculi.