彩超引导建立经皮肾镜钬激光碎石术前通道临床应用价值.docVIP

彩超引导建立经皮肾镜钬激光碎石术前通道临床应用价值 　　【摘要】 目的：探讨彩超引导下建立经皮肾镜术前通道在微创经皮肾穿刺取石术（minimally invasive percutaneous nephrolithotomy，MPCNL）中的临床应用价值，并评价其安全性及疗效。方法：选取2012年1月-2014年4月本院收治的91例上尿路结石患者，在彩超引导下根据结石的具体分布情况选择穿刺点并建立术前工作通道，行经皮肾镜联合钬激光碎石取石术，观察其疗效。结果：本组91例患者在彩超引导下均一次性穿刺成功，成功建立经皮肾盂通道，无大出血等并发症产生。结论：采用彩超引导穿刺建立经皮肾镜工作通道成功率高，创伤小，安全性好，具有较高的临床应用价值。 　　【关键词】 超声引导； 经皮肾穿刺取石术； 肾结石 　　Clinical Application Value of Establishing Renal Channel in Percutaneous Nephrolithotomy with Holmium laser Under Ultrasound-guided/JIN Zhong-min，WANG Ping，TANG Zhi-yong，et al.//Medical Innovation of China，2014，11（12）：064-066 　　【Abstract】 Objective：To discuss the clinical application value of establishing renal channel in minimally invasive percutaneous nephrolithotomy（MPCNL） with ultrasound-guided，and to evaluate the safety and feasibility.Method：91 patients with upper urinary tract calculus in our hospital from January 2012 to April 2014 were selected，they were treated with MPCNL with holmium laser，puncture points were selected and then channels were established under ultrasound-guided according to the distributions of calculi before MPCNL，and the effect was observed.Result：Reliable percutaneous access into the pelvicaliceal system was established successfully in all 91 patients under ultrasound-guided.No massive hemorrhage or other severe complications occurred.Conclusion：Establishing channel under ultrasound-guided in MPCNL is safe and minimally invasive with a high success rate.It has high value in clinical application. 　　【Key words】 Ultrasound-guided； Percutaneous nephrolithotomy； Kidney calculi 　　First-author’s address：The Fourth People’s Hospital of Shenyang City，Shenyang 110031，China 　　doi：10.3969/j.issn.1674-4985.2014.12.024 　　微创经皮肾镜手术（minimally invasive percutaneous nephrolithotomy，MPCNL）是通过经皮肾盂通道对肾盂、肾盏及输尿管上段疾病进行诊断和治疗的技术，是泌尿外科手术中的一个重要组成部分，被广泛应用于治疗肾结石及输尿管上段结石，已逐渐取代了传统开放手术治疗肾结石的方式[1-2]。经皮肾镜手术成功的关键在于建立一条准确可靠的经皮肾盂通路，以往通道的建立均在X线透视下进行操作，对术者和患者的身体均具有一定程度的放射性损害，且定位显示也经常会有偏差。采用超声监视引导下建立经皮肾盂通路，由于具有安全、实时、准确性高等