论文部分内容阅读
目的探讨彩超定位微造瘘一期经皮肾镜取石术治疗上尿路结石的优势和疗效。方法采用彩超定位微造瘘一期经皮肾镜取石术治疗上尿路结石30例,其中肾结石18例,输尿管上段结石12例。肾结石长径1.5～3.5cm,输尿管上段结石长径0.8～1.8cm。术中利用彩超定位,选定穿刺肾盏后常规彩色多普勒显示肾内血管,避免穿刺扩张时损伤肾段动脉及叶间动脉,降低术中、术后出血机率。结果30例均行一期取石术,其中一次取石25例,2次取石5例,单通道取石24例,双通道取石6例,结石清除率90%。手术时间1～3h,平均110min。术中有明显出血1例,经处理后出血减少,继续手术,未输血;无术后大出血及其他并发症。平均住院时间9d。结论彩超定位微造瘘一期经皮肾镜取石术是一种有效的治疗上尿路结石的方法,创伤小,出血少,恢复快。
Objective To investigate the advantages and effects of color Doppler ultrasound-guided micro-percutaneous nephrectomy in the treatment of upper urinary calculi. Methods A total of 30 cases of upper urinary tract calculi were treated with color-ultrasonography and micro-percutaneous nephrolithotomy, including 18 cases of kidney stones and 12 cases of upper ureteral stones. The diameter of kidney stones 1.5 ~ 3.5cm, the length of the upper ureteral stones 0.8 ~ 1.8cm. Intraoperative use of color Doppler ultrasound, the selected calyx after conventional color Doppler renal blood vessels to prevent damage to the renal arteries and interlobar arteries when the puncture to reduce the intraoperative and postoperative bleeding probability. Results Thirty patients underwent one stage lithotripsy. Among them, 25 cases were taken stone once, 5 stones were taken twice, 24 stones were taken by single-channel, 6 were taken by double-channel stone, the stone clearance rate was 90%. Surgery time 1 ~ 3h, an average of 110min. One patient had obvious hemorrhage during operation, the hemorrhage after treatment was reduced, the operation was continued, and blood was not transfused; no postoperative bleeding and other complications occurred. The average length of stay 9d. Conclusion Color Doppler ultrasound-guided micro-percutaneous nephrolithotomy lithotripsy is an effective treatment of upper urinary tract stones, less trauma, less bleeding, rapid recovery.