【摘要】 目的探讨单纯B超定位建立皮肾通道的操作技巧与临床价值。方法2005年11月~2008年4月对128例不同肾结石、输尿管上段结石患者行经皮肾手术时,单独采用B超定位引道穿刺建立经皮肾通道,对其操作方法、技巧、穿刺成功率、穿刺成功时间、并发症和临床价值进行回顾性分析,总结评价。结果31例术前定位,97例术中直接定位穿刺,操作中我们单独使用B超进行定位,一次定位穿刺成功率95.31%(122/128),二次穿刺成功率98.43%(126/128),定位穿刺平均耗时5~8min,无严重并发症发生,术后随访结石清除率82.35%(98/119),与近年国内以X线定位为主的相关报道结果一致。早期9例失败行开放手术处理。结论单用B超定位技术建立经皮肾通道安全、有效、定位准确、图像清晰、组织分辨率高、操作技巧易掌握、使用方便、临床效果廊,未来必将成为主流定位方式,甚至成为经皮肾技术定位引导方式的新的金标准,值得推广。更多还原

【Abstract】 Objective To investigate the operational techniques and clinical value of developing renal tract solely under the B-ultrasound direction.Methods Under the guidance of B-ultrasound solely,from November 2005 to April 2008,128 cases with renal stone or upper urinary tract calculus were established renal tract for operation.The Clinical data including operational methods and techniques,the success rate and time of percutaneous nephrolithotomy,and complications were analyzed retrospectively.Results Thirty-one cases were localized before operation.97 patients were localized and developed renal track in operation,under the guidance of B-ultrasound solely.The success rate of one localization is 95.31%(122/128),and the success rate of second localization is 98.43%(126/128).The average time for location and developing renal track is 5～8minutes.The success rate of one-stage operation is 88.28%(113/128).The success rate of second-stage operation is 92.97%.No case experienced severe complications.The stone-free rate amounted to 82.3%(98/119).In the early stage,9 cases were operated after the failure of percutaneous nephrolithotomy.Conclusion It should be a mainstream methods,even should be the golden standard for location methods of percutaneous renal techniques,on account of the advantages,such as the safety,effect,simple,clear images,high resolution.it is worthwhile to be widely used.更多还原