X光单独与联合超声定位在经皮肾镜取石术中并发症情况的比较  

Comparison of the complication for percutaneous nephrolithotomy(PCNL)under B-ultrasound and/or X-ray guidance for upper urinary calculi

作　　者：黄丽娟 刘乔保[2] 马鸿钧[3] 自富春 张威 安琼 皇甫刚华 李发俊 

机构地区：[1]云南结石病医院泌尿外科,昆明650032 [2]云南省第一人民医院泌尿外科,昆明650032 [3]昆明医科大学第一附属医院泌尿外科,昆明650032

出　　处：《中华腔镜泌尿外科杂志（电子版）》2013年第5期10-13,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较X光联合超声定位与单独X光定位下经皮肾镜治疗上尿路结石的并发症。方法回顾性分析自2008年12月至2012年1月,应用X光联合超声定位经皮肾镜治疗上尿路结石624例,单独X光定位经皮肾镜治疗上尿路结石300例,对两种定位方式并发症发生率进行比较。结果 924例手术中发生并发症22例,并发症发生率2.38%(22/924),联合定位组发生并发症7例,并发症发生率1.12%(7/624),单独X光定位组发生并发症15例,并发症发生率5.00%(15/300)。联合定位组出血6例,介入栓塞治疗2例,介入治疗率0.32%(2/624);单独X光定位组出血11例,介入栓塞治疗5例,介入治疗率1.67%(5/300)。术后出现感染2例,联合定位组发生1例,单独X光定位组发生1例,未发生感染性休克。气胸2例,均为单独行X光定位组。液气胸合并肠管损伤1例,为单独经X光定位组。两种定位方式并发症发生情况进行统计学分析,联合定位组较单独X光定位组出血及周围脏器损伤明显减少,两种定位方式感染的发生率无统计学差异。结论超声与X光联合定位穿刺建立通道可减少并发症的发生,是治疗上尿路结石的安全有效方法。Objective To compare the complication for percutaneous nephrolithothotomy （PCNL） under B-ultrasound and/or X-ray guidance for upper urinary calculi. Methods From December 2008 to January 2012, 624 patients with upper urinary calculi were treated by PCNL under B-ultrasound and X-ray guidance and 300 patients under X-ray guidance alone. The incidence rate of complications was compared. Results Complications occurred in 22 cases. The incidence rate was 2.38%（22/924）. 7 cases got complications under B-ultrasound and X-ray guidance. The incidence rate was 1.12%（7/624）. 15 cases got complications under only X-ray guidance. The incidence rate was 5.00% （15/300）. Haemorrhage occurred under B-ultrasound and X-ray guidance in 6 cases, 2 cases of which were treated by super-selective arterial embolization. The incidence rate was 0.32%（2/624）. Haemorrhage occurred under only X-ray guidance in 1 i cases. Five cases of then were treated by super-selective arterial embolism. The incidence rate was 1.67%（5/300）. Infection after operation was found in 2 patients. Each group has one. No infective shock occurred. Pneumothorax happended in two cases under only X-ray guidance. One occurred hydropneumothorax with injury of colon under only X-ray guidance. The incidence rate of complications for bleeding and injury of pleura and colon under B-ultrasound and X-ray guidance waslower. But there＇s no difference in infection. Conclusions PCNL under B-ultrasound and X-ray guidance can reduce compications and that are safe and effective .

关 键 词：超声 X光 定位 经皮肾镜 并发症 

分 类 号：R691.4[医药卫生—泌尿科学]