彩超定位微造瘘在经皮肾镜取石术中的临床价值  

Clinical Value of Minimally Invasive Percutaneous Nephrolithotomy under Color Ultrosound Guidance

作　　者：万银绪[1] 张永富[1] 赵阳[1] 史本康[2] 

机构地区：[1]滨州医学院烟台附属医院泌尿外科,山东烟台264100 [2]山东大学齐鲁医院泌尿外科

出　　处：《临床泌尿外科杂志》2011年第2期113-115,共3页Journal of Clinical Urology

摘　　要：目的:探讨彩超定位微造瘘一期经皮肾镜取石术治疗肾及输尿管上段结石的优势和疗效。方法:采用彩超定位微造瘘一期经皮肾镜取石术治疗肾及输尿管上段结石286例.其中肾结石208例.输尿管上段结石78例。肾结石长1.5～5.5 cm,输尿管上段结石长径0.8～2.0 cm。术中利用彩超定位,选定穿刺肾盏后常规彩色多谱勒显示肾内血管,避免穿刺扩张时损伤肾段动脉及叶间动脉。扩张经皮肾通道至F_(?).应用WOLF F_(?)微型肾镜或F_(89.8)输尿管镜,气压弹道碎石。结果:286例均行一期取石,其中一次取石249例,二次取石37例。单通道取石227例,双通道取石50例,3通道9例。结石取净率87%。手术时间60～180min,平均110 min。术中术后无大出血病例,发热16例,脓毒血症2例。平均住院时间9天。结论:彩超定位微造瘘一期经皮肾镜取石术是一种有效的治疗肾及输尿管上段结石的方法,创伤小,出血少,恢复快。Objective： To study the advantage and effect of primary minimally invasive percutaneous nephrolithotomy （MPCNL） in treatment of renal and upper ureteral calculi under color ultrosound guidance. Methods： 208 cases of renal calculi and 78 cases of upper ureteral calculi underwent MPCNL under color ultrosound guidance. The length of renal calculiis 1.5-5.5 cm and upper ureteral calculiis 0.8-2.0 cm. Color ultrosound was used to show the blood vessel of renal after selecting the renal calices for MPCNL, which less the risk of damaging segmental artery or the interlobar artery during dilating. After channel were dilated to F16 ,MPCNL were porformed under F10 mini-nephroscope or F8/9.8 ureteroscope. Results：286 cases were all primary MPCNI., among these , 249 cases for one time ,37 cases for two times. 227 cases of one channel, 50 cases of two channels, 9 cases of three channels. The stone-free rate was 87% . The mean operating times 110 min （range from 60 to 180）. 16 cases had fever and 2 cases suffered Pyemia, yet no hemorrhea case. the average length of stay is 9 days. Conclusions： Primary minimally invasive percutaneous nephrolithotomy under color ultrosound guidance in treatment of renal and upper ureteral calculi is effective, minimally invasive, less haemorrhagia.

关 键 词：肾及输尿管上段结石 彩超定位 经皮肾镜取石术 

分 类 号：R691.4[医药卫生—泌尿科学]