超声引导穿刺经皮肾镜气压弹道碎石术治疗无积水肾结石的应用价值

Application value of ultrasound-guided percutaneous nephrolithotripsy in treatment of renal calculi without hydronephrosis

目的探讨超声引导穿刺建立皮肤、肾脏通道,经皮肾镜气压弹道碎石术治疗无积水肾结石的应用价值。方法 157例无积水肾结石患者,穿刺前患侧输尿管插管逆行留置5F输尿管导管,生理盐水持续滴注或注射器推注以充盈肾盂,制造人工肾积水。超声引导下穿刺目标肾盏,建立皮肤肾脏通道。结果 157例患者均一次性成功建立皮肤肾脏通道,141例一期单一通道碎石,5例一期两通道碎石,11例二期碎石。患者均未发生气胸、腹腔脏器损伤等严重并发症。结论超声引导经皮肾镜碎石治疗无积水肾结石具有准确、安全及方便,避免X线损伤等优点,可作为首选方法。

Objective To evaluate the application value of establishment of skin - kidney access under ultrasound guidance, and percutaneous nephrolithotripsy in treatment of renal calculi with non - dilated collecting system. Methods One hundred and fifty - seven patients with renal stone without hydronephrosis were enrolled in this study. A stent was inserted into the pelvis throngh cystoscope, and saline was instilled or injected to dilate collecting system. The skin - kidney access was obtained by ultrasound guidance. Results All the patients were punctured successfully by one pricking. Phase I lithotripsy was performed in 141 cases and delayed phase II lithotripsy was performed in 11 cases with one work- tunnel, the second percutaneous nephrolithotriosy work - tunnel was established in phase I lithotripsy in 5 cases. There were no severe complications, such as pneumothorax and injury of abdominal organs in the patients. Conclusion Treatment of renal stone without hydronephrosis by percutaneous nephrolithotriosy under ultrasound guidance is accurate, safe and convenient, it can be the first method in clinic.