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目的探讨超声实时引导经皮肾镜取石术（PCNL）治疗上尿路结石的临床应用价值。方法选择85例上尿路结石行PCNL治疗的患者，术中采用B超实时定位引导经皮肾穿刺，少数病例辅助X线进行通道确认，分别建立1～2个工作通道，同期或分期进行PCNL处理。术后统计通道建立数量，各期手术完成情况，总净石率和并发症发生情况。结果85例患者共建立经皮肾穿刺通道105个，大多数通道为一期完成。其中每侧肾脏单通道80个，2个通道5个。Ⅰ期完成手术73例，其中两侧同期完成手术4例；Ⅱ期8例，Ⅲ期2例。术后辅助ESWL治疗6例，经1～3次治疗结石排净，总净石率91.5%。术后发现胸腔积液2例，气胸1例。无中转开放手术和并发周围脏器损伤及术后因肾脏大出血需动脉栓塞治疗病例。结论超声实时引导PCNL是治疗上尿路结石的有效手段。
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更新时间：2015-03-30
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超声实时引导经皮肾镜取石术治疗上尿路结石85例临床分析
Rea-time ultrasoundguided percutaneous nephrolithotomy for upper urinary tract stones (a report of 85 cases)
微创医学 201403期 页码：311-313
作者机构：(广西武宣县人民医院泌尿外科,武宣县545900)
基金信息：（广西武宣县人民医院泌尿外科，武宣县545900）作者简介：李云最（1967～），男，本科，副主任医师，
- 中文简介
- 英文简介
- 参考文献
Objective：To investigate clinical application value of realtime ultrasoundguided percutaneous nephrolithotomy(PCNL) in patients with upper urinary tract stones. MethodsUnder the real -time guidance of ultrasound, 85 patients with upper urinary stones were undergone with PCNL in one stage or by stages, with few patients assured 1 or 2 tunnels with assisted X-ray. ResultsOne hundred and five tracts were successfully established in the first stage of operation for 85 cases, with the majority finished in the first stage, of which, 80 were in single tract in one kidney, 5 were double tracts. Seventythree patients finished operation in one procedure, among which, 4 were performed PCNL in both sides of kidney, 8 patients in the second procedure, and 2 patients in the third procedures. Six cases received combined ESWL for 1 to 3 times after PCNL. Clearance rate was 91.5%. Two cases of hydrothorax and 1 aerothorax were observed. No surrounding organ injury, conversion to open surgery, or arterial embolization for kidney hemorrhage occurred. ConclusionsRealtime ultrasoundguide PCNL is effective in treating upper urinary stones
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