彩超定位下经皮肾镜取石术通道丢失后再次建立的临床分析  

Clinical Study of PCNL Channel Reestablishment after Loss under Color Ultrasound Localization

作　　者：谢建兵[1] 刘锦裕[1] 陈绮仁[2] 李励献[1] 唐怀鼎 XIE Jianbin;LIU Jinyu;CHEN Qiren;LI Lixian;TANG Huaiding(Department of Urology,The Affiliated Hospital of Putian University,Putian Fujian 351100,China;Department of Thyroid and Breast Surgery,The Affiliated Hospital of Putian University,Putian Fujian 351100,China)

机构地区：[1]莆田学院附属医院泌尿外科,福建莆田351100 [2]莆田学院附属医院甲乳外科,福建莆田351100

出　　处：《莆田学院学报》2024年第5期43-46,76,共5页Journal of putian University

基　　金：莆田学院科研项目(2019071)。

摘　　要：为评价经皮肾镜取石术(PCNL)在彩超定位穿刺通道丢失后借助X线引导再次建立通道的手术安全性和可行性,收集莆田学院附属医院自2020年7月至2023年12月行彩超定位下PCNL患者情况,比较彩超定位下建立经皮肾通道且术中无通道丢失、彩超定位下建立经皮肾通道失败或术中通道丢失后在X线引导下重建经皮肾通道这两类患者的结石清除率、手术及住院时间、术后并发症发生率等。结果发现:两类患者在结石清除率和术后出血行介入栓塞、脓毒血症发生率方面差异无统计学意义(P>0.05),在手术时间、住院时间和术后发热、肾周积液发生率方面差异有统计学意义(P<0.05)。得出如下结论:行彩超定位下PCNL通道丢失后,利用X线引导可有效再次建立通道,结石清除率高,无严重手术并发症,是重建经皮肾通道的可靠选择。To evaluate the surgical safety and feasibility of percutaneous nephrolithotomy(PCNL)with the guidance of X-ray guidance for reestablishing the puncture channel after loss of color Doppler ultrasound positioning,the patient situation of PCNL surgery under color Doppler ultrasound positioning at Putian University Affiliated Hospital from July 2020 to December 2023 was collected.The stone clearance rate,surgical and hospitalization time,and postoperative complication ratio of two groups of patients who established a percutaneous renal channel under color Doppler ultrasound positioning without channel loss during surgery and reestablished the percutaneous renal channel under X-ray guidance after channel loss during surgery were compared.The results showed that there was no statistically significant difference between the two groups in terms of the stone clearance rate,the incidence of postoperative bleeding,interventional embolization and sepsis proportion(P>0.05);There were statistically significant differences between the two groups in terms of the surgery and hospitalization time,the incidence of postoperative fever,and perirenal effusion(P<0.05).The conclusions are as follows:after the PCNL surgical channel is lost under ultrasound positioning,X-ray guidance can effectively establish a new channel with high stone clearance rate and no serious surgical complications,which is a reliable choice for the reconstruction of percutaneous renal channel.

关 键 词：彩超定位 X线定位 建立通道 经皮肾镜取石术 

分 类 号：R699[医药卫生—泌尿科学]