便携式无线超声在经皮肾镜术中的初步应用

Preliminary application of portable wireless ultrasound for percutaneous nephrolithotomy

目的探讨UProbe-2无线超声在经皮肾镜碎石取石术(PCNL)中引导经皮肾穿刺的准确性、安全性、有效性和便携性。方法选取中山大学附属第三医院2016年5月至8月收治的合并中重度积水的上尿路结石患者18例,术前先行CT尿路成像(CTU)预定位,确定基本穿刺区域及路径,术中采用UProbe-2无线超声实时引导经皮肾穿刺,建立通道后应用钬激光碎石。记录患者的临床资料,术中评价指标和术后并发症情况,并比较UProbe-2无线超声与传统超声的便携性差异。结果 UProbe-2无线超声引导PCNL穿刺均取得成功,引导目标肾盏穿刺16例一次取得成功,2例二次成功;经皮肾穿刺时间(3±1)min;手术时间(45±10)min;一期结石清除率为88.89%(16/18),其余2例患者需行PCNL二期手术,所有手术均未出现大出血、肠道损伤、气胸等并发症。结论 UProbe-2无线超声引导具有准确性高、安全性好、效率高及便携性强等特点,其在PCNL术中具有推广应用价值。

Objective To evaluate the accuracy, safety, efficacy and portability of UProbe-2 wireless ultrasound for tract establishment during percutaneous nephrolithotomy（PCNL）. Methods Eighteen patients with upper urinary tract calculi and uronephrosis from the Third Affiliated Hospital of Sun Yat-sen University during May 2016 to August 2016 were enrolled in our study. Computed tomography of urinary system（CTU） was performed to determine the region and way of percutaneous puncture before operation. UProbe-2 wireless ultrasound was used to guide the percutaneous puncture during operations. Patient demographics, baseline characteristics, and operative and postoperative outcomes were recorded. And then the portability of UProbe-2 wireless ultrasound and traditional ultrasoundin were compared. Results All the operations were completed successfully. Only 2 of them needed a secondary percutaneous puncture, while the others were successful punctured at the first time. The mean puncture time was（3±1） min, the mean operation time was（45±10） min. First operation stone clearance rate was 88.89%（16/18）, only 2 cases with residual stones needed a second operation. No seriously complications, including massive hemorrhage, intestinal injury, aerothorax and so on occurred after operations. Conclusion UProbe-2 wireless ultrasound has the characteristics of high accuracy, safety, efficiency and portability in PCNL, which has potential application value in PCNL.