导航超声联合光纤输尿管肾镜在无明显积水肾结石PCNL术中的应用  

Application of ultrasound navigation system combined with fiber optic ureteroscope in percutaneous nephrolithotomy for kidney stones without obvious hydronephrosis

作　　者：彭家玺 许陈祥[1] 周红庆[1] Peng Jiaxi;Xu Chenxiang;Zhou Hongqing(Department of Urology,Qujing Affiliated Hospital of Kunming Medical University,Qujing 655000,China)

机构地区：[1]昆明医科大学附属曲靖医院泌尿外科,曲靖655000

出　　处：《微创泌尿外科杂志》2024年第5期303-307,共5页Journal of Minimally Invasive Urology

基　　金：云南省曾国华专家工作站基金项目(201005AF150065);曲靖市第一人民医院院级科研项目(2022YJKTY13)。

摘　　要：目的:探讨Sonix GPS导航超声结合光纤输尿管肾镜在无明显积水肾结石经皮肾镜取石术(PCNL)中的临床应用效果及安全性。方法:将2021年6月至2023年10月昆明医科大学附属曲靖医院90例无明显积水肾结石患者随机分为观察组及对照组,每组45例。两组术前体质量指数(BMI)、结石CT值、结石大小、肾积水程度比较差异无统计学意义(P>0.05)。观察组在Sonix GPS导航超声结合光纤输尿管肾镜引导下穿刺行PCNL,对照组在普通超声引导穿刺行PCNL。分析并比较两组患者经皮肾穿刺针数、穿刺时间、血红蛋白下降值、RBC下降值、手术时间、结石清除率、手术并发症等指标。采用SPSS25.0软件进行统计学分析。结果:观察组的穿刺针数、穿刺时间、血红蛋白下降值、RBC下降值均优于对照组(P<0.05);两组患者在通道丢失、手术时间、肾盂损伤、术后发热(≥38.5℃)、结石清除率方面比较差异无统计学意义(P>0.05)。结论 Sonix GPS导航超声结合光纤输尿管肾镜辅助定位穿刺应用在无明显积水肾结石PCNL中是安全有效的,可以提高穿刺过程的可视化程度,有效提高穿刺成功率,降低手术风险。Objective:To investigate the clinical effect and safety of Sonix GPS ultrasound navigation system combined with fiber optic ureteroscope in percutaneous nephrolithotomy(PCNL)for kidney stones without obvious hydronephrosis.Methods:90 patients with kidney stones without obvious hydronephrosis in Qujing Affiliated Hospi-tal of Kunming Medical University from June 2021 to October 2023.All of the patients were randomly divided into the observation group and the control group,with 45 cases in each group.There was no statistically significant differ-ence in the comparison of two groups'preoperative body mass index(BMI),stone CT value,stone size,and degree of hydronephrosis(P>0.05).The observation group performed PCNL with puncture under the guidance of Sonix GPS navigation system combined with fiber optic ureteroscope,while the control group performed PCNL with punc-ture under the guidance of conventional ultrasound.The number of percutaneous renal puncture,puncture time,post-operative blood routine changes,operation time,stone clearance rate and postoperative complications were observed between the two groups.SPSS 25.0 statistical software was used for statistical analysis.Results:The observation group was better than the control group in number of percutaneous renal puncture,intraoperative puncture time,he-moglobin decrease and RBC decrease(P<0.05).There were no statistically significant differences between the two groups in channel loss rate,operative time,the renal pelvis injury,postoperative fever(≥38.5℃)and stone clear-ance rate(P>0.05).Conclusion:Sonix GPS ultrasound navigation system combined with fiber optic ureteroscope as-sisted positioning puncture in percutaneous nephrolithotomy for kidney stones without obvious hydronephrosis is safe and effective,which can improve the visualization of the puncture process,effectively improve the success rate of puncture and reduce the surgical risk.We need to further explore the effective fusion of various techniques to improve the accuracy and safety of PCNL.

关 键 词：GPS导航超声系统 肾结石 经皮肾镜取石术 

分 类 号：R699.2[医药卫生—泌尿科学]