SonixGPS穿定位系统在经皮肾镜碎石取石术中应用体会.docVIP

SonixGPS穿刺定位系统在经皮肾镜碎石取石术中应用体会 　　【摘要】 目的：探讨SonixGPS超声引导穿刺定位系统在PCNL中应用的有效性及安全性。方法：2015年4月-2016年8月，笔者应用SonixGPS超声导航引导下行经皮肾穿刺，建立16～22F皮肾通道处理上尿路结石患者72例，患者术前均行尿培养，尿常规、彩超、CT和IVU等检查。手术均采用全麻，俯卧位，在SonixGPS超声定位系统的引导下，16G穿刺针穿刺目标肾盏并扩张建立16-22F皮肾通道，应用钬激光或第五代超声碎石清石系统进行碎石清石。结果：本组72例均一期穿刺成功并行一期碎石，手术时间30～145 min，平均（52±4.5）min；经皮肾穿刺时间1～7 min，平均（3.0±1.2）min。术中术后未出现大出血、肠道损伤、气胸等并发症，术后复查KUB，一期清石率为84.7%（61/72），7例患者残余结石行二次PCNL，4例有残余结石患者行ESWL治疗，1个月后均顺利排出。结论：SonixGPS影像穿刺定位系统在PCNL穿刺中可实时监控，及时显示穿刺针的位置，准确建立皮肾通道，穿刺时间短，可有效减少手术副损伤，提高穿刺成功率。 中国论文网 /6/viewhtm　　【关键词】 经皮肾镜取石术； SonixGPS； 穿刺； 肾结石 　　【Abstract】 Objective：To evaluate the feasibility and safety of using GPS-ultrasound guidance system in PCNL.Method：From April 2015 to August 2016，72 patients with upper urinary tract calculi were treated with PCNL under ultrasound guided puncture by SonixGPS navigation.All the patients were checked with urine routine，imageological examination，including plain abdominal film of kidney，ureter and bladder（KUB），ultrasonography，computed tomography and intravenous urography before preoperative.General anesthesia was used in all patients，all of them were adopted prone position.72 patients underwent PCNL by ultrasonic power（fifth generations of EMS） or holmium laser lithotripsy with the navigation of SonixGPS guidance positioning system.A 16G proprietary needle was inserted into the fornix of targeted alyx under the navigation of SonixGPS and established a channel of 16-22F.Result：The operation time was 30-145 min，the mean operative time was （52.0±4.5）min，and the time of making a successful percutaneous access to the renal collecting system from an appropriate calyx was 1-7 min，with a mean of （3.0±1.2）min.There was no occurrence of serious bleeding or injury of pleura and abdominal organs.Postoperative KUB demonstrated stone-free after primary procedure in 61 patients（84.7%），7 cases needed two-stage PCNL for residual stones，and 4 patient need extracorporeal shock wave lithotripsy.Conclusion：SonixGPS-ultrasound