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目的探讨在专业凸阵穿刺超声探头下行肾穹窿穿刺并评估其在经皮肾镜碎石术中的应用价值及技巧。方法收集98例共106侧肾结石患者,专业凸阵穿刺超声实时监测引导行肾穹窿穿刺法建立经皮肾通道。结果所有病例均穿刺成功并一期碎石取石,一期结石清除率达86.8%(92/106),手术时间15~42 min,平均(25.7±16.5)min,出血量20~150 ml,平均(60.8±40.5)ml,术后住院时间3~7 d,平均(3.8±1.9)d。未发生气胸、肠管损伤和出血而需要输血的患者。结论术中专业凸阵穿刺超声实时动态监测下肾穹窿穿刺法建立经皮肾通道成功率高,出血少,安全性高,结石清除率高。
Objective To investigate the value and technique of using the convex hull puncture ultrasound probe to perform the renal vault puncture and evaluate its application in percutaneous nephrolithotripsy. Methods A total of 98 patients with renal stones of 106 sides were collected. Percutaneous renal channels were established by real-time monitoring of the specialized convex array puncture ultrasound guided by the culmination of the renal vault. Results All the cases were successful in puncture and lithotripsy. The rate of primary stone removal was 86.8% (92/106), the operation time was 15-42 minutes (mean, 25.7 ± 16.5) min and the amount of bleeding was 20-150 ml (60.8 ± 40.5) ml, postoperative hospital stay of 3 to 7 days, with an average of (3.8 ± 1.9) d. Patients without pneumothorax, bowel injury, and bleeding requiring blood transfusions. Conclusion Intraoperative ultrasound-guided real-time monitoring of puncture ultrasound under the renal cul-de-sac method to establish a high success rate of percutaneous renal access, less bleeding, high safety, high rate of stone clearance.