【摘要】 目的比较X光联合超声定位与单独X光定位下经皮肾镜治疗上尿路结石的并发症。方法回顾性分析自2008年12月至2012年1月,应用X光联合超声定位经皮肾镜治疗上尿路结石624例,单独X光定位经皮肾镜治疗上尿路结石300例,对两种定位方式并发症发生率进行比较。结果 924例手术中发生并发症22例,并发症发生率2.38%(22/924),联合定位组发生并发症7例,并发症发生率1.12%(7/624),单独X光定位组发生并发症15例,并发症发生率5.00%(15/300)。联合定位组出血6例,介入栓塞治疗2例,介入治疗率0.32%(2/624);单独X光定位组出血11例,介入栓塞治疗5例,介入治疗率1.67%(5/300)。术后出现感染2例,联合定位组发生1例,单独X光定位组发生1例,未发生感染性休克。气胸2例,均为单独行X光定位组。液气胸合并肠管损伤1例,为单独经X光定位组。两种定位方式并发症发生情况进行统计学分析,联合定位组较单独X光定位组出血及周围脏器损伤明显减少,两种定位方式感染的发生率无统计学差异。结论超声与X光联合定位穿刺建立通道可减少并发症的发生,是治疗上尿路结石的安全有效方法。更多还原

【Abstract】 Objective To compare the complication for percutaneous nephrolithothotomy(PCNL) under B-ultrasound and/or X-ray guidance for upper urinary calculi.Methods From December 2008 to January 2012,624 patients with upper urinary calculi were treated by PCNL under B-ultrasound and X-ray guidance and 300 patients under X-ray guidance alone.The incidence rate of complications was compared.Results Complications occurred in 22 cases.The incidence rate was 2.38%(22/924).7 cases got complications under B-ultrasound and X-ray guidance.The incidence rate was 1.12%(7/624).15 cases got complications under only X-ray guidance.The incidence rate was 5.00%(15/300).Haemorrhage occurred under B-ultrasound and X-ray guidance in 6 cases,2 cases of which were treated by super-selective arterial embolization.The incidence rate was 0.32%(2/624).Haemorrhage occurred under only X-ray guidance in 11 cases.Five cases of then were treated by super-selective arterial embolism.The incidence rate was 1.67%(5/300).Infection after operation was found in 2 patients.Each group has one.No infective shock occurred.Pneumothorax happended in two cases under only X-ray guidance.One occurred hydropneumothorax with injury of colon under only X-ray guidance.The incidence rate of complications for bleeding and injury of pleura and colon under B-ultrasound and X-ray guidance was lower.But there′ s no difference in infection.Conclusions PCNL under B-ultrasound and X-ray guidance can reduce compications and that are safe and effective.更多还原