三维超声成像在微创经皮肾镜取石术中的应用

目的：评价三维超声成像在微创经皮肾镜取石术（MPCNL）中的应用价值。方法：2007年4月～2009年4月,对80例肾结石、输尿管上段结石患者术前行三维超声重建检查,确定最佳穿刺路径;建立经皮肾穿刺通道,行微创经皮肾镜取石术。结果：80例三维超声重建成像清楚显示了肾结石在肾盂肾盏系统中的准确位置、肾盂肾盏形态、肾积水状态及中后组肾盏结构。提供了最佳穿刺路径。80例结石诊断率及穿刺成功率100％,输尿管上段结石取净率100％,结石总取净率90％,未发生严重并发症。结论：三维超声重建能够提供精确的穿刺路径,减少穿刺并发症,对经皮肾镜取石术穿刺定位具有指导意义。

The Application of Three Dimensional Ultrasound Reconstruction in Mini-percutaneous Nephrolithotomy

Objective：To assess the value of three dimensional （3D） ultrasound reconstruction in mini-pereutaneous nephrolithotomy （MPCNL）. Methods： Eighty patients with renal or ureteral calculus underwent 3D ultrasound reconstruction preoperatively from April 2007 to April 2009 in order to choose an optimal percutaneous ap proach. The channel of percutaneous renal biopsy was constituted. All the patients were performed with MPCNL. Results：3D ultrasound reconstruction clearly showed that the exact location of kidney calculi in the renal pelvis and calyceal system, the shape renal pelvis and cup, hydronephrosis and the structure of middle and latter calyx. 3D imaging provided the best channel of biopsy. All the cases were punctured successfully, stone-free rate of upper u reteral calculus was 100 %, and the total stone rate reached 90%. No severe complications were recorded. Conclusions：3D ultrasound reconstruction could provide an optimal percutaneous renal biopsy approach. It also decreases the complications in MPCNL, and has guidance significance for the location of percutaneous renal biopsy.