徒手超声引导下经皮肾输尿管镜碎石术治疗肾结石的探讨  

Investigation on Free-hand Ultrasound-guided Percutaneous Nephrolithotomy or Nephrolithotripsy with Ureteroscope for Kidney Stones

作　　者：吴彩文[1] 何昌孝[1] 鄢世兵[1] 何伟[1] 袁正勇[1] 

机构地区：[1]四川省都江堰市人民医院泌尿外科,四川都江堰611830

出　　处：《现代预防医学》2012年第20期5482-5483,共2页Modern Preventive Medicine

摘　　要：目的探讨徒手超声引导及输尿管镜替代肾镜进行经皮肾镜手术的可行性。方法采用徒手超声引导下进行术中定位、穿刺,输尿管镜替代肾镜行经皮肾镜碎石术治疗肾结石35例,对其临床资料进行回顾性分析。结果 35例均成功建立皮肾通道并一期手术,其中单通道清除结石34例,双通道1例。2例行二期碎石清石术。总手术时间50～130 min,建立通道时间15～25 min,一期手术结石清除率为94.28%(33/35),无大出血、感染性休克等严重并发症。结论徒手B超引导下输尿管镜替代肾镜的经皮肾镜碎石术治疗肾结石安全、有效并且是可行的。OBJECTIVE To investigate the feasibility of performing free-hand ultrasound-guided percutaneous nephrolithotomy or nephmlithotripsy with uretemscope instead of nephroscope. METHODS Thirty-five consecutive patients with kidney stones were retrospectively studied, all of which underwent percutaneous nephrolithotomy or nephrolithotripsy using intraoperative free hand ultrasound-guided localization, nephmstomy and lithotripsy with uretemscope. RESULTS We established successfully the working channel and performed first-stage surgery in all 35 eases. Thirty-four cases were effectively cleared of kidney stones us ing singe channel while 1 using dual channels. Two underwent second-stage stone clearance. It took about 15-25 min to estab lish percutaneous working channel. Total operating time ranged 50-130 min. The rate of stone clearance was 94.28% （33/35）. There were no severe complications such as massive blood loss, septic shock. CONCLUSION Free-hand ultrasound-guided pemutaneous nephrolithotomy or nephmhthotripsy with uretemscope for kidney stones is safe, effective and feasible.

关 键 词：徒手B超引导 经皮肾镜术 肾结石 输尿管镜 

分 类 号：R693[医药卫生—泌尿科学]