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  

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

作　　者：赵益华[1] 蒋旭敏[1] 黄伟[1] 陈浩[1] 卢毅[1] 

机构地区：[1]温州医科大学附属乐清医院泌尿外科,浙江温州325600

出　　处：《温州医学院学报》2014年第12期913-916,共4页Journal of Wenzhou Medical College

基　　金：温州市卫生局科研基金资助项目(2014B53)

摘　　要：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。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.

关 键 词：肾结石 经皮肾镜取石术 B超 标准通道 

分 类 号：R691.4[医药卫生—泌尿科学]