经皮肾镜取石术患者通道大小的合理选择

Reasonable choice of percutaneous nephrolithotomy in patients undergoing channel size

目的:经皮肾镜取石术患者通道大小的合理选择刺探头引导在经皮肾穿刺的成功率和穿刺效果。方法:选取行经皮肾镜取石术的138例无明显积水肾结石患者的相关临床资料,根据肾穿时采用的不同通道大小分为16F通道组(46例)、20F通道组(46例)和24F通道组(46例)。所有的患者在术前均进行各项常规检查,比较这三种不同方法在经皮肾穿刺的成功率以及穿刺效果。结果:所有的患者均成功地建立了通道,无穿刺失败和中转开放性手术的病例,24F通道组的1次穿刺成功率为67.39%,≤2次穿刺成功率为89.13%,高于20F通道组和16F通道组,差异有统计学意义(P<0.05);24F通道组的平均穿刺次数最少。24F通道组有41例(89.13%)经肾盏穹窿部进入,穿刺效果优于20F通道组和16F通道组,差异有统计学意义(P<0.05)。结论:24F通道用于经皮肾穿刺的实时引导,成功率较高,穿刺效果较好,方便实用,临床上值得推广。

Objective Percutaneous nephrolithotomy Patients channel size reasonable choice probing head guided percutaneous puncture success rate and effect. Method A retrospective analysis of our hospital percutaneous nephrolithotomy surgery clinical data of patients with kidney stones had no water in 138 cases,according to the size of the different channels used divided into16 renal biopsy F channel group（ 46 cases）,20 F channel group（ 46 cases） and 24 F channel group（ 46 cases）. All patients underwent preoperative routine examination items,compare three different methods percutaneous puncture success rate and effect. Results All patients were successfully established channel,no puncture failure and transit cases open surgery,24 F channel group 1 puncture success rate was 67. 39%,≤2 puncture success rate was 89. 13%,higher than 20 F 16 F channel group and channel group,the difference was statistically significant（ P〈 0. 05）; the average number of punctures at least 24 F-channel group. 24 F channel group 41 cases（ 89. 13%） by the kidneys into the light fornix puncture channel group was better than 20 F and 16 F-channel group,the difference was statistically significant（ P〈 0. 05）. Conclusion 24 F-channel for realtime guided percutaneous renal biopsy,the success rate is higher,better puncture,convenient and practical,clinical worth promoting.