局部浸润麻醉超声引导下经皮肾镜取石术

Treatment of renal calculi with percutaneous nephrolithotomy under the guidance of ultrasound and local infiltration anesthesia

目的探讨局部浸润麻醉下超声引导经皮肾穿刺取石术(PCNL)治疗肾结石或输尿管上段结石的方法及效果。方法该组42例肾结石或输尿管上段结石均采用超声引导,局部浸润麻醉下行经皮肾穿刺取石术。结果42例均一期穿刺造瘘成功,39例一期成功PCNL,3例患者因脓肾改行二期PCNL,一期手术结石清除率为83.8%。手术时间为15～80min,平均55min,无严重并发症。结论局麻下超声引导PCNL治疗多发性肾结石或输尿管上段结石具有操作简单、创伤小、并发症少、恢复快、结石清除率高等优点,可作为部分简单肾结石或输尿管上段结石的治疗方法。

Objective To evaluate the feasibility and availability of percutaneous nephrolithotomy（PCNL） under the guidance of ultrasound and local infiltration anesthesia on renal calculi or ureteral calculus. Methods We retrospectively investigated 42 patients with renal calculi or ureteral calculus who underwent PCNL. All the 42 cases underwent PCNL with local infiltration anesthesia under the guidance of ultrasound. Results Among 42 cases, 39 cases were stone free after one stage PCNL, 3 cases stone free after two stages PCNL for renal pyonephrosis. The total stone free rate was 83.8%. The operative duration was 55 min （15- 80 min）. No severe complications were observed. Conclusions PCNL under the guidance of ultrasound and local infiltration anesthesia offers advantages with respect to easy operation, less invasion, less complications, high stone free rate. It is a minimally invasive way in treatment of simple renal and ureteral calculus.