【摘要】 目的 :评估B超引导下建立经皮肾穿刺通道行经皮肾镜取石术 (PCNL)的方法及效果。方法 :收治10 2例肾结石患者 ,前 5 0例先行B超定位下经皮肾微穿刺造瘘 ,置入F10 硅胶引流管 ,1周后经造瘘管放入导丝 ,B超引导下用Cook扩张器扩张穿刺通道 ,再行PCNL ;对后 5 2例患者行一期B超引导下建立经皮肾穿刺通道PCNL。结果 :10 2例患者 1次取净结石 6 9例 ,1周后经瘘管再行PCNL取净结石 2 3例 ,两次手术结石总取净率为 91.0 % ;手术时间平均 2 .5h ;术中 6例患者输血 ,输血量平均 2 30ml。早期 2例患者出现腹腔积液 ,1例术后2周出现肾动静脉瘘 ,1例肾盂输尿管连接处狭窄 ,经及时治疗后痊愈。结论 :单用B超引导建立经皮肾穿刺通道行PCNL技术上可行 ,能在基层医院推广。更多还原

【Abstract】 Purpose:To evaluate the feasibility and availability of sonographically percutaneous nephrolithotomy (PCNL) in treatment of renal calculi.Methods:Here reported 102 cases of renal calculi in this group. The first 50 cases underwent two stage procedure for PCNL. That is a percutaneous micronephrostomy guided by ultrasound B established and one week later the PCNL was carried out in which a guiding wire was introduced through the nephrostomic tubing followed by a series of dilation solely under the guidance of B sonography.While a nephrostomy sheath was placed properly, a 26F nephroscope or a ureteroscope was used through to manage the calculi. Results:69 cases presented stone free on the first PCNL and 33 others still had residual stone and underwent the second management. So the total stone clearence amounted to 91.0 % by the first and second operation.The average operation time was 2.5 h;6 cases had transfusion during the PCNL and averaged 230 ml; The complications were discovered of extravasation of fluid in abdominal cavity on 2 cases, renal artery vein fistula on 1 case and UPJ stricture on 1 cases.All these complications were treated properly.Conclusions:Solely sonographic guidance is available to the PCNL and it is, indeed, applicable to all urologic centers.更多还原