超声引导在经皮肾镜取石中的应用进展

Progress in Application of Ultrasound Guidance in Percutaneous Nephrolithotomy

尿路结石是一种易复发性疾病,终身复发风险高达50%。鹿角形结石是尿石症中较难清除的一种结石,而经皮肾镜取石术(PCNL)作为一种肾结石常用的微创治疗方法,可将近80%的鹿角形结石患者的结石清除。近年来,体外冲击波碎石治疗肾结石的比例持续降低,选择输尿管镜和PCNL碎石的病例显著增多,尤其是PCNL的使用频率呈上升趋势。PCNL的成功主要在于通道的建立,无论是仰卧位还是侧卧位均需要精准地通过肾乳头到达肾盏,从而尽可能地将结石全部清除,而PCNL通道建立的成像引导方式对安全性和有效性起重要作用。

Urinary calculi are a recurrent disease with a reported lifetime recurrence risk of up to 50%.Staghorn calculus is a difficult stone to remove in urolithiasis,while percutaneous nephrolithotomy(PCNL),as a commonly used minimally invasive treatment for kidney stones,can remove all the calculi in nearly 80%of cases of staghorn calculus.In recent years,the proportion of extracorporeal shock wave lithotripsy continues to decline in the treatment of kidney stones,and the number of cases choosing ureteroscopy and PCNL lithotripsy has increased significantly,especially the frequency of the use of PCNL is on the rise.The success of PCNL mainly lies in the establishment of channels.In both supine position and lateral position,it’s needed to accurately pass through the renal nipple to reach the renal calyx so as to remove all the calculi as much as possible.Therefore,the imaging guidance method established by PCNL channel plays a crucial role in its safety and effectiveness.