【摘要】 目的探讨六线四区超声定位法在经皮肾镜碎石取石术(percutaneous nephroscope lithoipsy,PCNL)中的应用。方法选取2016年10月至2018年10月,因上尿路结石行PCNL的患者200例,按病例住院号的单双号将其分为观察组与对照组,每组100例。观察组和对照组分别采用六线四区超声定位法、常规超声定位法穿刺建立经皮肾通道,然后行碎石取石术,比较2组的手术和并发症情况。结果 2组均手术过程顺利,术中或术后无转开放性手术病例。观察组手术用时少于对照组[(53.2±18.3)min比(67.4±21.5)min,P<0.05];术中出血量少于对照组[(78.3±28.6)mL比(96.6±31.4)mL,P<0.05]。2组一期上尿路结石的清除率比较差异无统计学意义(87.0%比85.0%,P>0.05)。观察组因出血而行介入治疗的比例低于对照组(2%比11%,P<0.05)。2组均未见腹腔脏器损伤,总并发症发生率比较差异无统计学意义(10%比14%,P>0.05)。结论六线四区法超声定位能精准定位目标肾盏,为穿刺选择恰当的路径,避免肾血管及周围脏器损伤,可有效提高手术效率和减少手术并发症。更多还原

【Abstract】 Objective To explore the clinical application of six-line and four-zone ultrasound localization in percutaneous nephrolithotomy(PCNL).Methods From October 2016 to October 2018,200 patients with upper urinary calculi were treated with PCNL.According to the odd and even numbers of hospitalization,these patients were assigned to receive either six-line and four-zone ultrasound localization(observation group,n=100) or conventional ultrasonic localization(control group,n=100) for establishing percutaneous renal access.Operative outcomes and complications were compared between the two groups.Results The operation was completed successfully in both groups.No patients were converted to open surgery during and after operation.Compared with control group,both operation time and intraoperative blood loss decreased in observation group((53.2±18.3) minutes vs(67.4±21.5) minutes and(78.3±28.6)mL vs(96.6±31.4)mL,respectively;P<0.05).There was no significant difference between the two groups in the clearance rate of upper urinary tract stones in the first stage(87.0% vs 85.0%,P>0.05),as well as in the total incidence of complications(10% vs 14%,P>0.05).No abdominal organ injury was found in both groups.The proportion of patients undergoing interventional treatment due to bleeding in observation group was lower than that in control group(2% vs 11%,P<0.05).Conclusion The six-line and four-zone ultrasound positioning method can accurately locate the target calix,select the appropriate path for puncture,avoid damage to renal blood vessels and surrounding organs,improve surgical efficiency,and reduce operative complications.更多还原