穿刺架辅助超声引导下建立经皮肾镜通道的临床观察

目的探讨穿刺架辅助在超声引导下建立经皮肾镜通道的有效性和安全性。 方法我院自2016年10月至2017年12月成功实施经皮肾镜手术的肾结石患者106例，均在单纯超声下引导，并由穿刺架辅助穿刺建立通道，回顾性分析临床资料。 结果平均穿刺时间（35±18） s，平均穿刺数（1.3±0.9）次，一次性穿刺成功73例，手术时间为（67±39） min，手术失血量约（48±22） ml。结石位于左侧50例，右侧56例，经肾上、中、下盏通道数分别为78例、20例、8例，穿刺点位于第12肋上、下分别为81例、25例，术中及术后输血4例，胸膜损伤2例，液气胸并行胸腔闭式引流术1例，单次手术清石率87.7%（93/106）。 结论穿刺架辅助超声引导下建立经皮肾镜通道是一种有效、安全的方法。

Application of punture frame in establishing percutaneous nephroscope channel guided by ultrasound

ObjectiveTo investigate the clinical efficacy and safety of ultrasound-guided percutaneous nephroscopic surgery assisted by puncture frame. MethodsClinical data of 106 patients with kidney stones underwent ultrasound-guided percutaneous nephroscopic surgery from October, 2016 to December, 2017 in our hospital were analyzed retrospectively. The channel was established by puncture frame. ResultsThe average puncture time was (35±18) s, the puncture was performed for (1.3±0.9) times on average. The puncture was successfully performed at one time in 73 cases. The operation time was (67±39) min, and the intraoperative blood loss was (48±22) ml. The stones were located on the left in 50 cases and on the right in 56 cases. The channels were established through the upper, middle or lower calyces of the kidney in 78, 20 and 8 cases, respectively. The puncture site was located on the upper or lower 12th rib in 81 and 25 cases. Intraoperative and postoperative blood transfusion was given in 4 cases, pleural injury occurred in 2 patients, hydropneumothorax occurred in one case and closed thoracic drainage was performed. The stone removal rate after single surgery was 87.7% (93/106). ConclusionsEstablish percutaneous nephroscopic channel under ultrasound-guided assisted by puncture frame is an efficacious and safe approach.