【摘要】 目的探讨斜卧位B超引导微通道经皮肾输尿管镜碎石术治疗复杂肾结石的方法、疗效及安全性。方法对26例接受斜卧位B超引导微通道经皮肾输尿管镜碎石术治疗的复杂性肾结石患者的临床资料进行回顾性分析。结果本组26例患者均成功行一期取石,单一通道24例,双通道2例,一期取净结石率65.4%(17/26),有残石者联合体外震波碎石术,三个月内结石总排净率80.7%(21/26)。手术时间55~180min,术中出血量30~250mL;肾造瘘管留置时间平均5.2d,术后平均住院8.3d,未出现严重的并发症。结论微通道经皮肾输尿管镜碎石术治疗复杂肾结石具有损伤小,恢复快,住院时间短,结石清除率高,并发症少等优点,是治疗复杂性肾结石较好的微创方法;采用改良斜卧位,患者体位耐受性好,可采用持续硬膜外麻醉,不影响手术治疗效果;B超引导下穿刺具有简便、安全、无放射性损伤等优点,更易在基层医院推广应用。更多还原

【Abstract】 Objective To investigate the method and value of mini-percutaneous nephrolithotomy under ultrasound guidance in semi-supine position for renal complicated calculi.Methods The clinical data of 26 cases mini-percutaneous nephrolithotomy under ultrasound guidance in semi-supine position for renal complicated calculi were analyze retrospectively.Results Lithotripsy was successfully performed in all 26 cases,and single-channel technique was used in 24 patients and dual-pathway in 2.The stone free rate was 65.4%,the operative time 55～180 min,blood loss 30～250mL,and no serious complications occurred.4 cases with surplus calculus were cured with extracorporeal shock wave lithotripsy after operation.The average nephrostomy tube stay was 5.2 days and average hospitalization 8.3 days.Conclusions Mini-percutaneous nephrolithotomy has the advantages of less wound,fewer complications,quick recovery and high stone-free rate.In semi-supine position,patients can adopt a comfortable position and receive continued epidural anesthesia.It is more convenient and safe to puncture under ultrasound guidance,which is unlikely to cause radiation-induced injury and can be prevalently adopted in primary hospitals.更多还原