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目的探讨超声引导下肋间通路经皮肾镜取石术的疗效及安全性。方法2006年5月～2008年6月由一个手术小组完成110例超声引导下经皮肾镜取石术,62例采用肋间通路(第12肋上)经皮肾镜取石术(肋间通路组),48例采用肋下通路(肋缘下)经皮肾镜取石术(肋下通路组)。术前肋间通路组和肋下通路组分别有45例和36例行CT结石三维重建。结果肋间通路组结石取净率为72.6%(45/62),肋下通路组结石取净率为60.4%(29/48),2组结石取净率无统计学差异(χ2=1.818,P=0.178)。肋间通路组手术时间(78.6±5.1)min显著短于肋下通路组(102.4±7.1)min(t=-20.454,P=0.000)。肋间通路组及肋下通路组各有1例需要输血,肋间通路组有1例发生气胸,经保守治疗痊愈。结论肋间通路经皮肾镜取石术安全、有效。
Objective To investigate the efficacy and safety of percutaneous nephrolithotomy guided by ultrasound. Methods From May 2006 to June 2008, 110 cases underwent ultrasonography guided percutaneous nephrolithotomy by a surgical team and 62 cases underwent percutaneous nephrolithotomy (intercostal access group) ), And 48 cases were treated with percutaneous nephrolithotomy (subcostal approach) under the subcostal approach (under the costal margin). Preoperative intercostal access group and subcostal access group were 45 cases and 36 cases of CT three-dimensional reconstruction of the stone. Results The extraction rates of stones in the intercostal access group were 72.6% (45/62), while those in the subclavian access group were 60.4% (29/48). There was no significant difference in the two groups (χ2 = 1.818, P = 0.178). The operative time (78.6 ± 5.1) min in the intercostasis group was significantly shorter than that in the subclavian group (102.4 ± 7.1) min (t = -20.454, P = 0.000). One patient in the intercostal access group and the subcostal access group needed transfusion, one in the intercostal access group had pneumothorax, and was cured by conservative treatment. Conclusion Percutaneous nephrolithotomy is safe and effective.