超声引导下Ⅰ期经皮肾镜取石在鹿角形肾结石中的临床应用

Clinical application of ultrasound-guided I phase percutaneous nephrolithotomy in staghorn calculi without hydronephrosis

目的探讨超声引导下Ⅰ期经皮肾镜取石术在鹿角形肾结石中的临床应用价值。方法对45例鹿角形肾结石患者(肾结石伴积水者13例,无积水者32例)采用超声引导建立肾镜取石通道,行肾镜碎石取石术。结果13例鹿角形肾结石伴积水患者均1次穿刺成功,32例无积水型肾结石患者中17例1次穿刺成功,15例多次穿刺后成功建立理想的取石通道。45例患者均无胸膜损伤、腹腔脏器损伤、肾盂撕裂及肾脏穿通伤等严重并发症发生。结论超声引导建立肾镜取石通道方法安全简便,尤其提高了无积水型鹿角形肾结石患者经皮肾镜取石通道建立的准确性及安全性。

Objective To explore the clinical value of Ⅰ phase percutaneous nephrolithotomy （PCNL） under ultrasound guidance in staghorn calculi without hydronephrosis. Methods A total of 45 patients with staghorn calculi underwent PCNL under ultrasound guidance. Among them, 13 patients had hydronephrosis and 32 had no hydronephrosis. Results Nephroscopic channel was successfully established by one puncture in 13 patients with hydronephrosis and 17 patients without hydronephrosis. For the remaining 15 patients without hydronephrosis, nephroscopic channel was established by repeated puncture. All the patients had no serious complications such as pleural injury, abdominal visceral injury, pyelic laceration and renal penetrating injury. Conclusions Ultrasound-guided Ⅰ phase PCNL is safe and convenient, especially for staghorn calculi patients without hydronephrosis. It can improve the accuracy and security of PCNL.