经皮肾镜钬激光碎石取石术中超声引导体会

目的探讨经皮肾穿刺肾镜下钬激光碎石取石术(PCNL)中超声引导方法及避免肾与肾周组织损伤的技巧。方法回顾性分析106例肾及输尿管上段结石病人的PCNL临床资料,所有病例均在超声引导下穿刺建立手术通道并进行肾镜下钬激光碎石取石术。结果所有病例均一次穿刺成功,其中2例因双肾铸型结石留置造瘘管共分四次手术取净结石,出现肾周积液2例、肾周血肿1例。结论 PCNL术中应用超声引导穿刺成功率高,可实时观察手术过程,有效避免严重并发症的发生。

Objective To investigate the method of ultrasound in the guidance of percutaneous nephrolithotomy and the technique of avoid injuring kidney and perirenal organs. Methods Review and analyse the clinical data of 106 cases with kidney and ureter stones in percutaneous nephrolithotomy, all patients were established surgical access by the ultrasound-guided puncture and underwent percutaneous nephrolithotomy. Results All punctures were suceesfull, 2 cases of renal mold stones is divided into four times of surgery to take the net by indwelling fistula. Occurred perirenal effusion in 2 cases, perirenal hematoma in l case. Conclusion Guidance of ultrasound could improve the success rate of puncture in percutaneous nephrolithotomy and real-time observation of surgical procedures could effectively prevent the occurrence of serious complications.