论文部分内容阅读
目的:探讨彩超定位微造瘘一期经皮肾镜取石术治疗肾及输尿管上段结石的优势和疗效。方法:采用彩超定位微造瘘一期经皮肾镜取石术治疗肾及输尿管上段结石286例.其中肾结石208例.输尿管上段结石78例。肾结石长1.5～5.5 cm,输尿管上段结石长径0.8～2.0 cm。术中利用彩超定位,选定穿刺肾盏后常规彩色多谱勒显示肾内血管,避免穿刺扩张时损伤肾段动脉及叶间动脉。扩张经皮肾通道至F_(?).应用WOLF F_(?)微型肾镜或F_(89.8)输尿管镜,气压弹道碎石。结果:286例均行一期取石,其中一次取石249例,二次取石37例。单通道取石227例,双通道取石50例,3通道9例。结石取净率87%。手术时间60～180min,平均110 min。术中术后无大出血病例,发热16例,脓毒血症2例。平均住院时间9天。结论:彩超定位微造瘘一期经皮肾镜取石术是一种有效的治疗肾及输尿管上段结石的方法,创伤小,出血少,恢复快。
OBJECTIVE: To investigate the advantages and curative effects of color Doppler ultrasound-guided micro-ostomy in percutaneous nephrolithotomy for the treatment of renal and upper ureteral calculi. Methods: A total of 286 cases of upper ureter and upper ureteral calculi were treated with ultrasound-assisted micro-fistulation and percutaneous nephrolithotomy, including 208 cases of kidney stones and 78 cases of upper ureteral calculi. Kidney stones 1.5 ~ 5.5 cm long, long ureteral stones 0.8 ~ 2.0 cm in diameter. Intraoperative use of color Doppler ultrasound, selected puncture calyx after conventional color Doppler renal blood vessels to prevent the expansion of the renal artery puncture and interlobar artery injury. Expand the percutaneous renal access to F_ (?) .Application of WOLF F_ (?) Miniature nephroscope or F 89.8 ureteroscope, pneumatic lithotripsy. Results: A total of 286 patients underwent primary stone removal, of which 249 were stone-removed and 37 were stone-removed twice. Single-channel stone 227 cases, double-channel stone in 50 cases, 3 channels in 9 cases. Stone take rate of 87%. Surgery time 60 ~ 180min, an average of 110 min. No intraoperative hemorrhage cases, fever in 16 cases, 2 cases of sepsis. The average length of stay of 9 days. Conclusion: Color Doppler ultrasound-guided micro-percutaneous nephrolithotomy lithotripsy is an effective treatment of upper ureteral calculi and stones, less trauma, less bleeding, rapid recovery.