B超引导下斜仰卧位经皮肾镜取石术治疗上尿路结石95例报告

Report of 95 Cases on Ultrasonography-guided Percutaneous Nephrolithotomy for Treating Upper Urinary Calculi in Lateral Decubitus Position

目的：探讨B超引导下斜仰卧位微创经皮肾镜取石术治疗上尿路结石的临床应用价值。方法：采用斜仰卧位微创经皮肾镜取石术治疗上尿路结石95例，其中肾结石83例，输尿管上段结石12例，观察其治疗效果。结果：所有患者行MPCNL均成功，一期结石清除率82.1%（78/95），有17例结石残余，术后需用ESWL辅助治疗，无严重并发症发生，平均手术时间90min（50-120min），平均住院7.8d（5-9d）。结论：B超引导下斜仰卧位经皮肾镜取石术是安全而有效的，并可防止辐射对术者手术团队及患者的影响，进行微创经皮肾镜手术时，斜仰卧位对术者麻醉师及患者是一个良好的手术体位选择。

Objective：To evaluate the clinical efficacy of mini-percutaneous nephrolithotomy（MPCNL）with ultrasonogra-phy（US）-guided renal access in the lateral decubitus position for the treatment of upper urinary calculi. Methods：95 patients underwent MPCNL with US-guided renal access in the lateral decubitus flank position,including 83 cases of renal stones,and 12 cases of upper urethral calculi. Results：All 95（100% ）MPCNL procedures were successfully performed in the lateral decubitus position. Primary stone clearance was achieved in 78 cases（82. 1% ）. Residual stones occurred in 17 cases（17. 9% ）were treated further by extracorporeal shockwave lithotripsy（ESWL）. No serious complications oc-curred. The average operation time was 90（50 - 120）min and the average hospital stay was 7. 8（5 - 9）d. Conclu-sion：MPCNL with US-guided renal access in the lateral decubitus position,which is a favorable position for the patients, the surgeons and the anesthesiologists during the procedure,is safe and convenient,and prevents harmful effects of radia-tion for the surgical team,and the patient.