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目的探讨彩超引导技术在无积水肾结石经皮肾镜取石术(PNL)中的应用价值。方法 66例无积水肾结石患者随机分为彩超引导组(A组)与二维超声引导组(B组),每组33例,比较两组患者的手术效果及出血情况等指标。结果两组患者的手术时间、血清肌酐(SCR)、一期清石率差异均无统计学意义(P>0.05);B组术后血红蛋白(Hb)下降程度为(21.1±12.4)g/L,明显高于A组(15.0±7.9)g/L(P<0.05),B组手术输血率18.2%,明显高于A组3.0%(P<0.05);B组发生需选择性肾动脉栓塞治疗的严重出血1例。结论彩超组与二维超声组的PNL疗效相似,但彩超引导技术能明显降低无积水肾结石经皮肾镜手术严重出血的发生,值得在临床工作中推广使用。
Objective To explore the value of color Doppler ultrasound guided percutaneous nephrolithotomy (PNL) in the treatment of non-hydronephrotic nephrolithiasis. Methods Sixty-six patients with hydronephrosis without kidney stones were randomly divided into two groups: group A (color Doppler ultrasound) and group B (ultrasound guided group B), with 33 patients in each group. The operative effects and bleeding were compared between the two groups. Results There was no significant difference in operative time, serum creatinine (SCR) and primary stone ratio between the two groups (P> 0.05). The decrease of hemoglobin (Hb) in group B was (21.1 ± 12.4) g / L , Which was significantly higher than that of group A (15.0 ± 7.9) g / L (P <0.05). The transfusion rate of group B was 18.2%, significantly higher than that of group A (3.0%, P <0.05) Treatment of severe bleeding in 1 case. Conclusion The color Doppler echocardiography and two - dimensional echocardiography have similar effects on PNL. However, Doppler echocardiography can significantly reduce the incidence of severe hemorrhage in percutaneous nephrolithotomy without hydronephrosis, which is worth to be promoted in clinic.