B超引导“改良一步法”建立标准通道在经皮肾镜碎石术中的应用#br#

目的：探讨应用B超引导“改良一步法”建立标准通道在经皮肾镜碎石术中应用的安全性和可行性。方法：2013年4月至2014年10月我科应用B超引导“改良一步法”建立标准通道进行经皮肾镜碎石术患者共131例，对其通道建立过程及临床结果进行回顾性分析。结果：131例患者通过“改良一步法”均成功建立通道，共建立皮肾通道149个，一期单通道122侧，一期双通道8侧，一期三通道2侧，一期四通道1侧，二期新建通道1侧，平均单个通道建立时间为（6.36±1.04）min。通道建立过程中，扩张过深5例，致上尿路穿孔3例和对侧肾实质损伤2例。无术中术后严重出血、邻近脏器损伤发生。结论：超声引导下“改良一步法”建立标准皮肾通道技术具有安全、可行、简便的优点，值得临床推广应用。

Application of establish standard percutaneous renal access by ultrasound-guided “improved one-step method” in percutaneous nephrolithotomy

Objective: To investigate the safety and efficacy of establishing standard percutaneous renal channel using ultrasound-guided “improved one-step method”. Methods: A total of 131 patients with urinary calculi underwent percutaneous nephroscope lithotripsy using ultrasound-guided “improved one-step method” to establish standard percutaneous renal channel in our department from April 2013 to July 2014. The operation process and results of 131 cases were now retrospectively analyzed. Results: Channel in one hundred and thirty-one patients through the “improved one-step” was success fully established, I period of single-channel was establisbed in 122 cases, dual-channel in 8 cases, three-channel in 3 cases and II stage of new channel in 1 case, the time for setting up a single channel was 6 minutes on average. In the process of establishing channel, expanded too deep in 5 cases, including the upper urinary tract perforation in 3 cases and contralateral renal parenchyma injury in 2 cases. None of the patients suffered from severe loss of blood or destruction of adjacent organs during intraoperative or postoperative. Conclusion: As a technology of establishing standard percutaneous renal channel, it is safe and convenient and effective, which is worth of clinical promotion.