SonixGPS导航超声与普通超声引导下经皮肾镜治疗肾结石的疗效比较

目的比较SonixGPS导航超声系统与普通超声穿刺定位引导下经皮肾镜碎石取石术（PCNL）治疗肾结石的疗效。 方法选取2016年1月至2016年12月我院确诊为肾结石患者115例，男75例，女40例，年龄（45±10）岁；左肾结石50例，右肾结石65例，均伴有不同程度肾积水；结石最大径（4.3±1.6） cm。全部患者均行经皮肾镜钬激光碎石术，其中59例采用SonixGPS导航超声系统建立经皮肾通道，56例采用超声引导下建立通道，比较两组患者在穿刺时间、穿刺出血量、一次性穿刺建立通道成功率、败血症发生率、迟发性出血率、一期结石清除率等。 结果115例患者除2例超声引导下建立通道时出现通道迷失改二期手术外，其余113例手术过程顺利，无肠道及胸膜损伤，SonixGPS导航组及超声组手术穿刺时间分别为（3.9±1.0）min及（5.0±2.0）min，穿刺出血量分别为（26±9）ml及（28±12）ml，一次性穿刺成功率分别为96.6%及82.1%，术后败血症发生率分别为1.69%及1.78%，迟发性出血率分别为3.4%及8.9%，一期结石清除率分别为94.9%及82.1%。两组患者在性别、年龄、结石位置、肾积水程度及结石大小方面差异无统计学意义（P>0.05）；而在穿刺时间、一次性穿刺成功率及一期结石清除率指标差异存在统计学意义（P<0.05）。 结论SonixGPS导航超声系统引导下行PCNL是安全有效的，相比普通超声定位具有明显优势，是一种值得推荐的穿刺引导方法。

Comparison of clinical efficacy using the guidance of SonixGPS ultrasound navigation system and general ultrasound for percutaneous nephrolithotomy

ObjectiveTo compare clinical efficacy using the guidance of SonixGPS ultrasound navigation system and general ultrasound for percutaneous nephrolithotomy. MethodsOne hundred and fifteen patients with kidney stone underwent PCNL from January 2016 to December 2016 in our hospital. There were seventy-five males and forty females, mean age was (45±10) years. All patients underwent percutaneous nephrolithotomy with holmium laser. Fifty nine cases established percutaneous renal access under the guidance of SonixGPS ultrasound navigation system, and 56 cases setted up percutaneous renal access by general ultrasound. The differences of two groups in the puncturing time, blood loss in puncturing process, success rate of disposable puncture, incidence of sepsis, incidence of delayed hemorrhage, phaseⅠstone clearance rate were compared by statistical analysis software. ResultTwo cases under the guidance of general ultrasound got channel lost and were transferred to phaseⅡ, the percutaneous renal access was successfully established in the other 113 patients without intestinal and pleura damage. The puncture time of SonixGPS navigation group and general ultrasound were(3.9±1.0) min and (5.0±2.0) min respectively, blood loss in puncturing process were (26±9) ml and (28±12) ml respectively. The success rate of disposable puncture was 96.6% and 82.1% respectively, the incidence of sepsis was 1.69% and 1.78% respectively, the incidence of delayed hemorrhage was 3.4% and 8.9% respectively, phaseⅠstone clearance rate was 94.9% and 82.1% respectively. No significant differences were found between the two groups in terms of gender, age, stone location, stone size and degree of hydronephrosis (P>0.05). Significant differences were identified between the two groups in the puncturing time, the success rate of disposable puncture and phaseⅠstone clearance rate (P<0.05). ConclusionsSonixGPS ultrasound navigation system applied for PCNL is safe and effective, which is a recommended guided approach in PCNL.