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目的评价超声定位在经皮输尿管镜钬激光碎石(PCUHL)中的应用价值。方法回顾性分析2004年3月至2009年12月我院泌尿外科肾结石患者178例,全麻俯卧位下行PCUHL术。结果 178例肾结石患者中173例在超声引导下穿刺成功,其中168例一次穿刺成功,5例两次穿刺成功,一次穿刺成功率达到94.4%;I期取净结石148例,II期取净结石6例,I期结石清除率达88.1%;术后平均住院时间为6.48±2.39 d。输血率为2.3%,术后发现胸腔积液2例,术后感染性休克1例,恶性高热2例,均予积极治疗后好转,所有患者均无邻近脏器的损伤发生。173例经皮输尿管镜钬激光碎石患者中153例得到随访,分别随访3个月至2年,均无手术相关并发症发生。结论超声引导下PCUHL术安全有效,创伤小、恢复快,有较大的应用价值,值得推广。
Objective To evaluate the value of ultrasound in percutaneous ureteroscopic holmium laser lithotripsy (PCUHL). Methods A retrospective analysis of 178 patients with urinary calculi in our hospital from March 2004 to December 2009, PCUHL surgery in prone position. Results Of the 178 patients with renal calculi, 173 cases were successfully punctured under ultrasound guidance. Among them, 168 cases were successful in one puncture, 5 cases were successful in two punctures and the success rate was 94.4% in one puncture. In stage I, net stones were taken in 148 cases and in stage II 6 cases of stone, I stone clearance rate of 88.1%; average postoperative hospital stay was 6.48 ± 2.39 d. The blood transfusion rate was 2.3%. Pleural effusion was found in 2 cases, postoperative septic shock in 1 case and malignant hyperthermia in 2 cases. All patients were treated with active treatment and all patients had no adjacent organ injury. A total of 153 patients with percutaneous ureteroscopic holmium laser lithotripsy were followed up from 3 months to 2 years respectively. No operative complications occurred. Conclusion Ultrasound-guided PCUHL is safe and effective, with less trauma and faster recovery. It is of great value and worth promoting.