超声实时定位技术在经皮肾镜碎石术治疗肾盏无明显扩张肾结石中的应用  

The clinical use of real time poisoning technology in PCNL for treating kidney stone patients with no obvious target renal calyx dilation

作　　者：李翔[1] 龙清志[1] 陈兴发[1] 贺大林[1] 何辉[1] 

机构地区：[1]西安交通大学医学院第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2016年第8期589-592,共4页Journal of Modern Urology

摘　　要：目的超声引导经皮肾镜碎石术(PCNL)目前已广泛应用于临床,但穿刺难度较大,特别是对于肾盏无明显积水的患者实施精确穿刺尤为困难。本文旨在探讨一种新型的超声实时定位系统(SonixGPS)在PCNL治疗肾盏不扩张或轻微扩张肾结石中的临床价值。方法回顾性分析2012年6月至2015年12月共131例肾盏积水<1cm的肾结石患者,其中79例患者接受Sonix GPS超声引导PCNL(SonixGPS-PCNL),52例接受普通超声引导PCNL(C-PCNL)。分析、比较两组患者术前基线资料,术中相关指标以及术后并发症发生率。结果两组患者术前基线指标大致相似,结石清除率以及手术后并发症发生率无明显差异,与传统超声相比,SonixGPS技术使穿刺更加快速精确,成功穿刺时间由(15.42±6.52)min降至(8.15±5.15)min,术中出血更少,手术前后血红蛋白的下降由(2.07±1.04)mg/L降至(1.58±0.74)mg/L,而且SonixGPS-PCNL组患者手术时间及住院时间更短。结论与传统超声相比,SonixGPS超声实时定位系统能够帮助术者实施更加准确、快速、安全的穿刺,尤其对于肾盏无明显扩张的患者更加适用。此外SonixGPS系统可以直观观察并追踪针的轨迹,从而降低了操作难度,对于初学者尤为有益。Objective Ultrasound guided percutaneous nephrolithotripsy （PCNL） is wildly used in clinical practice. However, the puncture is difficult especially for patients with no obvious dilation in target renal calyx. The purpose of this study is to investigate the clinical value of a novel Sonix GPS technology for PCNL in treating upper urinary tract stone patients with no obvious target renal calyx dilation. Methods This retrospective analysis included a total of 131 kidney stone patients with no obvious dilation in renal calyx treated during Jun. 2012 and Dec. 2015. Of them, 79 underwent SonixGPS guided PC- NL and 52 received conventional ultrasound guided PCNL. The baseline preoperative parameters, operative parameters and postoperative complications were recorded and evaluated Results There were no significant differences in stone clearance rate and postoperative complications between the two groups. Compared with conventional PCNL, Sonix GPS technology made puncture quicker and more accurate ; the puncture time was reduced from （15.42±F 6.52）min to （8.15 ± 5.15）min; the decrease of hemoglobin was dropped from （2.07± 1.04）mg/L to （1.58±0.74）mg/L. And Sonix GPS technology caused less blood loss, and needed shorter operation time and hospital stay. Conclusion Sonix GPS technology helps urologists to perform PCNL more efficiently and safely, especially in the difficult puncture cases with no obvious dilation in renal calyx. Besides, this tech- nology helps to overcome the technological barriers and shorten learning curve.

关 键 词：经皮肾镜碎石术 超声实时定位技术 肾结石 肾脏出血 肾盏积水 

分 类 号：R692.4[医药卫生—泌尿科学]