超声引导侧卧位经皮肾微造瘘肾镜碎石治疗复杂性肾结石  

Treatment of complex renal calculi by minimally invasive percutaneous nephrolithotomy in lateral decubitus position with ultrasonography-guided:a report of 40 cases

作　　者：陈起引[1] 韩瑞发[1] 

机构地区：[1]天津医科大学天津市泌尿外科研究所,天津300211

出　　处：《哈尔滨医科大学学报》2011年第4期360-362,365,共4页Journal of Harbin Medical University

摘　　要：目的探讨超声引导侧卧微创经皮肾镜治疗肾结石的疗效和安全性。方法回顾性分析本院采用超声引导侧卧位经皮肾镜碎石、取石治疗肾结石40例(45肾)临床资料。单发肾盂结石18例,多发性结石12例,铸形结石15例,均在超声引导下健侧卧位经皮肾镜碎石、取石。结果全部成功获得经皮肾穿刺通道。手术时间65～190 min,平均96 min。结石单次清除率71.1%,两次手术结石总清除率93.3%,平均出血量120 mL,术中均未输血,无腹腔脏器损伤。结论超声引导侧卧位经皮肾镜碎石、取石治疗肾结石疗效及耐受性良好。Objective To investigate the clinical value and safety of minimally invasive pereutaneous nephrolithotomy in lateral decubitus position under ultrasound guidance in the treatment of complex renal calculi. Methods Minimally invasive percutaneous nephrolithotomy, in lateral decubitus position and under ultrasound guidance, performed on 40 patients （45 kidneys） with renal calculi, 23 males and 17 females, aged 44. 3 （22-65） , 18 single stone in pelvis, 12 multiple stone and 15 stag horn stone. Results Successful access was achieved in 45 kidneys （100%）. The operative duration was 96 （65 -190） minutes. One patient underwent failed percutaneous nephrolithotomy and turned to pyelolithotomy. Stone were cleaned by once operation in 32 （71.1%） kidneys, and stone in other 10 （22.2%） kedneys were cleaned by second operation. Only 3 （6.7 % ） kidneys needed ESWL after percutaneous nephrolithotomy. Abdominal viscera was not injured and blood was not transfused during all operations. Conclusion Minimally invasive percutaneous nephrolithotomy in lateral decubitus position under ultrasound guidance is an efficient and safe treatment for complex renal calculi. Furthermore, this method is apt to tolerate by the patients.

关 键 词：侧卧位 B型超声波 经皮肾镜取石术 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]