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在经皮取肾石术中肾脏的正确定位十分重要,一般认为经12肋下途径能穿至肾脏者容易成功,也较安全。作肾穿造口前必须复习腹部平片及IVP以确定结石的大小和部位,肾集尿系统与肋骨、肝、脾和膈的相对位置。但这些片子大多是病人在仰卧位时拍摄的,而肾穿时病人处于俯卧位(术侧抬高30°)。这种位置的改变使肾脏与上述器官的相对位置发生了变化,为了证实肾脏移动的方向及机率,作者分析了50例连续肾穿取石病人仰、俯卧位时肾脏与12肋相应位置的变化。
The correct positioning of the kidneys in percutaneous nephrolithotomy is very important. It is generally believed that it is easy and safe to pass through the inferior vena cava to the kidneys. Nephrostomy must be reviewed before the abdominal plain film and IVP to determine the size and location of stones, renal urine system and the ribs, liver, spleen and diaphragm relative position. However, most of these films were taken by the patient in supine position, while the patient was in prone position (30 ° elevation in operation) during renal wear. In order to confirm the direction and the probability of renal movement, the author analyzed the changes of the corresponding positions of kidney and 12 ribs in the patients who were in the prone and prone position of 50 consecutive patients with renal puncture stone.