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目的:探讨GPS导航超声系统(Sonix GPS)引导定位穿刺在经皮肾取石术(PCNL)中的优势及安全性。方法:2012年5月~2012年9月,我们应用Sonix GPS行经皮肾穿刺,建立F16皮肾通道进行取石处理复杂肾结石22例,其中男17例,女5例,年龄46~70岁,平均51.2岁。重复肾畸形合并结石1例,肾多发结石16例,铸型肾结石2例,输尿管上段结石并肾结石3例。全部患者采用全身麻醉,用预先消毒好的超声探头在11肋间或12肋缘下区域扫查,了解结石的分布、位置、大小及和集合系统的关系情况,确定穿刺径路,皮肾通道建立成功后全部应用钬激光进行碎石。结果:借助Sonix GPS穿刺,22例患者全部一次成功。除1例多发结石因残余结石行二期PCNL外,其余21例患者均一期取石成功,无一例出现术中或术后严重并发症。结论:Sonix GPS可以实时追踪并显示穿刺针的方向和深度,特别对于经皮肾穿刺取石手术初学者,可以帮助清楚显示穿刺针位置,提高穿刺成功率,缩短学习曲线,可为PCNL超声定位穿刺提供一种新的选择。
Objective: To investigate the advantages and safety of Sonix GPS guided percutaneous nephrolithotomy in percutaneous nephrolithotomy (PCNL). Methods: From May 2012 to September 2012, 22 cases of complex renal calculus were treated with Sonix GPS through percutaneous nephric puncture and F16 renal access was performed. Among them, 17 were males and 5 were females, ranging in age from 46 to 70 years. Average 51.2 years old. 1 case of kidney stones with renal abnormalities, 16 cases of multiple kidney stones, 2 cases of mold kidney stones, 3 cases of upper ureteral calculi and kidney stones. All patients underwent general anesthesia with a pre-sterilized ultrasound probe in 11 intercostal or 12-ribbed area under the scan to understand the distribution of stones, location, size and the relationship with the collection system to determine the success of the puncture path, After all the holmium laser lithotripsy. Results: With Sonix GPS puncture, all 22 patients were successful. Except for 1 case of multiple stone because of residual stones in stage 2 PCNL, the other 21 cases were successful in one stage of stone extraction without any serious intraoperative or postoperative complications. Conclusion: Sonix GPS can track and display the direction and depth of the puncture needle in real time. Especially for beginners with percutaneous nephrolithotomy, it can help to clearly show the position of puncture needle, improve the puncture success rate and shorten the learning curve. It can be used for PCNL Provide a new choice.