侧卧斜仰截石位经皮肾镜碎石取石术中标准通道“四步法”扩张的临床体会

Clinical experience of four-shot dilation in lateral oblique lithotomy position for standard-tract percutaneous nephrolithotomy

目的探讨"四步法"建立标准通道在侧卧斜仰截石位经皮肾镜碎石取石术(PCNL)中应用的安全性和可行性。方法该科2017年5月-2017年12月应用"四步法"建立标准通道行侧卧斜仰截石位PCNL患者共30例,对其通道建立过程及结果进行回顾性分析。结果目标肾盏成功建立标准通道,结石最大径线0.8~6.7 cm,手术时间(88.19±7.08)min,术前术后血色素变化(-0.06±1.83)g/L,包膜下血肿1例;无输血者,无周围邻近脏器损伤。结论 PCNL"四步法"建立标准通道是安全有效的,值得推广。

Objective To evaluate the feasibility,safety and efficacy of for standard-tract percutaneous nephrolithotomy(PCNL).Metheds 30 patients were performed PCNL by four-shot dilation in lateral oblique lithotomy position from May 2017 to December 2017.Clinical data included patients’demographics and stone characteristics,total operating time,preoperative and postoperative hemoglobin concentrations,tract dilatation failures,complications and transfusions were collected and analyzed.Results The targeted calix could be entered with a success rate of 100.00%.Mean stone size was 0.8~6.7 cm and mean operative time was(88.19±7.08)min.The mean hemoglobin decrease was(-0.06±1.83)g/L.Renal subcapsular hematoma was found in 1 case,but no one was needed transfusion and there were no visceral,pleural,collecting systems or vascular injuries.Conclusion Fourshot dilation in lateral oblique lithotomy position for standard-tract percutaneous nephrolithotomy is safe and effective,which is worth of clinical promotion.