B超联合X线引导定位下微创经皮肾镜治疗复杂性肾结石的体会

目的:比较B超联合X线和单纯X线引导建立微通道经皮肾镜治疗复杂性肾结石的安全性以及临床疗效。方法:2005年12月～2011年12月收治复杂性肾结石患者457例,按引导定位方法不同分为两组,单纯X线组和B超&X线组,对其临床资料进行回顾性分析。结果:本组457例患者均成功建立经皮肾通道,无1例中转开放手术。结论:B超和X线C臂机联合定位引导的MPCNL治疗复杂性肾结石,优势互补,取长补短,有效地减少了手术并发症的发生,提高了经皮肾镜工作通道建立的成功率及安全性,还减少了医生和患者放射暴露,具有良好的临床效果。

Objective：To evaluate the safety and clinical efficacy of minimally invasive percutaneous nephrolithotomy（MPCNL） for treatment of complicated renal calculi under the guidance of B ultrasound combined with X-ray.Methods：From Dec 2005 to Dec 2011,we accepted 457 cases of complicated renal calculi.The cases are divided into two groups：X-ray alone group and B ultrasound ＆ X-ray group.And the clinical data were retrospectively analyzed.Results：457 cases in the group were successfully established mini-tracts of PCNL,no case was converted to open surgery.The operation of only three cases in X-ray alone group were suspended,and diverted two-staged MPCNL due to bleeding after the tracts of PCNL were successfully established.They stayed in the hospital for 4 ～ 7（5.3 ± 1.2） days after the operation.Conclusions：MPCNL for treat ment of complicated renal calculi under the guidance of B ultrasound combined with X-ray can effective reduce the occurrence of surgical complications,improve the success rate and safety of establishing the tracts of PCNL,and decrease the amount of radiation for the doctors and patients beause the advantages of B ultrasound and X-ray were mutual complementarity.The procedure is of good clinical efficacy.