普通超声定位经皮肾镜取石术开展早期的病例分析与经验总结  

Data analysis and experience of ordinary ultrasonography guided percutaneous nephrolithotomy in the early stage

作　　者：吴喜链[1] 董忠[1] 吴锦标[1] 谢骐同 甘妙平[1] 向天哲[1] 吴杰英[2] Wu Xilian Dong Zhong Wu Jinbiao Xie Qitong Gan Miaoping Xiang Tianzhe Wu Jieying(Department of Urology, Huizhou Municipal Central Hospital, Huizhou 516001, China Department of Urology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China)

机构地区：[1]惠州市中心人民医院泌尿外科,广东516001 [2]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2017年第4期32-35,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨普通超声在开展超声定位经皮肾镜取石术(PCNL)早期中的应用价值及其方法。方法分析总结惠州市中心人民医院自2012年7月至2015年6月由同一术者完成的共496例超声定位PCNL手术资料,其中第一年111例,第二年172例,第三年213例;轻度肾积液122例,中度肾积液186例,重度肾积液188例,所有患者均使用普通超声进行定位引导穿刺,进而建立取石通道并完成手术。结果所有患者均手术成功,无中转开放手术。3年共496例,在开展手术过程中,前期以中重度肾积液为主,后期则无明显侧重。术后血红蛋白下降值为(11±6)g/L,其数值在前后期无明显差异。3年的结石取净率分别为73.9%、79.7%、83.1%,二期手术占比分别为9.9%、5.2%、4.2%;未出现因肾内血管出血进行介入治疗病例,2例因肋间血管损伤分别进行局部切开止血及介入栓塞止血。结论在开展超声定位PCNL早期,利用普通超声,掌握正确的方法及技巧,能安全有效的完成手术,适用在各级医院开展手术,有利于上尿路结石患者在各级医院的分流治疗。Objective To explore the value and skill of ordinary ultrasonography guided percutaneous nephrolithotomy（PCNL） in the early stage. Methods Four hundred and ninety six patients treated with ordinary ultrasonography guided PCNL from July 2012 to June 2015 were retrospectively analysed, including 111 patients in the first year, 172 patients in the second year, and 213 patients in the third year. One hundred and twenty two patients suffered mild hydronephrosis, 186 moderate degrees, and 188 severe degrees. Results All operations were completed successfully without turning to open surgery. The majority of patients had moderate and severe hydronephrosis in the prophase, however, they was no difference in the anaphase. The decrease of hemoglobin after surgery was（11±6） g/L, which was no difference between the prophase and the anaphase. The stone-free rates were 73.9%, 79.7% and 83.1% respectively, and secondary surgery rates were 9.9%, 5.2% and 4.2% respectively. No interventional therapy was operated for nephrorrhagia. Two cases of intercostal vessels were damaged and treated with open surgery and interventional therapy respectively. Conclusions It is safe and effective to apply ultrasound guided PCNL in the early stage with right method and skills. This could make it more convenient to treat patients with upper urinary tract stone in different level hospitals.

关 键 词：超声 定位 经皮肾镜 经验 

分 类 号：R699[医药卫生—泌尿科学]