超声在标准经皮肾镜碎石清石术中的应用(附246例报告)

Application of ultrasound-guided technology in precutaneous nephroscope lithotrity(with report of 246 cases)

目的探讨超声在标准经皮肾镜碎石清石术中的应用价值,总结超声引导经皮肾镜碎石清石术的技术要点。方法系统回顾我院采用超声引导标准经皮肾镜碎石清石术治疗246例肾脏、上段输尿管结石患者的临床资料。结果本组246例均成功穿刺建立经皮肾通道。一期碎石清石术235例,二期碎石清石术11例。结石清除率88.6%(218/246),平均手术时间78min,平均住院时间13.6d,无严重并发症发生。术中发生导丝脱出7例,工作鞘脱出8例,冲洗液外渗2例,均在B超引导下采取适当处理方法顺利完成手术。结论超声引导标准经皮肾镜碎石清石术治疗肾脏、上段输尿管结石安全有效。超声在穿刺定位、引导监测、疗效观察、帮助解决术中困难、防止并发症等方面有重要价值。

Objective To investigate the value of ultrasound technology in precutaneous nephroscope lithotrity,and summarize the main points of ultrasound-guided technology.Methods A total of 246 patients with percutaneous nephrolithotripsy by ultrasound guidance were retrospectively analyzed.The ultrasound technology in localization,path design,guidance and observation were retrospectively analyzed.Results The 246 cases were applied with successful puncture nephroscope channel.The stone clearance rate was 88.6%（218/246）.The mean time of the operation was 78 minutes,mean time of hospital stay was 13.6 days.No serious complication was observed.By operation,the puncturation wire prolapse occurred in 7 cases,the work ensheasing prolapse occurred in 8 cases,the rinse exosmosis occurred in 2 cases.These cases have been in B-mode ultrasound-guided with appropriate handling method to purse the successful completion of the operation.Conclusions The ultrasound-guided percutaneous nephrolithotripsy was efficacious and safe for renal calculi and upper ureteral calculi.The ultrosonography is valuable for localization,guidance,observation during operation and prevent complications with significant value.