穿刺架在超声引导经皮肾镜取石术通道建立中的临床应用。

The Clinical Application of Puncture Frame in Establishing Ultrasound Guided Percutaneous Nephrolithotomy Access.

机构信息

Department of Urology, The People's Hospital Of Leshan, Leshan City, 614000, China.

Department of Gastroenterology, The People's Hospital Of Leshan, Leshan City, 614000, China.

出版信息

Urol J. 2020 Jun 23;17(4):358-362. doi: 10.22037/uj.v0i0.5587.

DOI:10.22037/uj.v0i0.5587

PMID:32207135

Abstract

PURPOSE

To investigate the clinical efficacy and safety of ultrasound-guided percutaneous nephrolithotomy (PCNL) assisted by a puncture frame.

MATERIALS AND METHODS

Clinical data of 106 patients with nephrolithiasis who underwent ultrasound-guided percutaneous nephrolithotomy from October 2016 to December 2017 in our hospital were analyzed retrospectively. The channels were established by the assistance of the puncture frame.

RESULTS

The mean puncture time was 35 ± 18 seconds, the puncture was performed 1.3 ± 0.9 times on average. The puncture was successfully performed at first attempt in 73 cases. The mean operation time was 67.3 ± 39.2 min, and the mean intraoperative blood loss was 48 ± 22 mL. The stones were located on the left in 50 (47.2%) cases, and on the right in 56 (52.8%) cases. Channels were established through the upper, middle and lower calyces of the kidney in 78 (73.6%), 20 (18.9%), and 8 (7.5%) cases, respectively. The puncture sites were located on the upper and lower of 12th rib in 81 (76.4%) and 25 (23.6%) cases. Intraoperative and postoperative blood transfusion was given in four cases. Pleural injury occurred in two cases, and hydropneumothorax occurred in one case in whom closed thoracic drainage was performed. The stone free rate after a single surgery was 87.7% (93/106).

CONCLUSION

Establishing a percutaneous nephrolithotomy access tract under ultrasound guidance using the puncture frame is an efficacious and safe approach.

摘要

目的

探讨超声引导下穿刺架辅助经皮肾镜取石术（PCNL）的临床疗效和安全性。

材料与方法

回顾性分析我院 2016 年 10 月至 2017 年 12 月 106 例肾结石患者行超声引导下经皮肾镜取石术的临床资料，通道由穿刺架辅助建立。

结果

平均穿刺时间为 35±18 秒，平均穿刺 1.3±0.9 次。73 例首次穿刺成功。平均手术时间 67.3±39.2min，平均术中出血量 48±22ml。结石位于左侧 50 例（47.2%），右侧 56 例（52.8%）。经肾盂中上盏建立通道 78 例（73.6%），经肾盂中下盏建立通道 20 例（18.9%），经肾上盏建立通道 8 例（7.5%）。穿刺点位于 12 肋上、下分别为 81 例（76.4%）、25 例（23.6%）。4 例术中、术后输血。2 例出现气胸，1 例出现液气胸，行胸腔闭式引流。单次手术结石清除率为 87.7%（93/106）。