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目的评价经皮肾镜下碎石的体位及引导设备的选用及疗效。方法回顾性分析我院2006年10月至2007年11月,52例上尿路结石及狭窄应用经皮肾镜治疗。选择俯卧位、斜卧位在C臂机及B超下定位穿刺术中、术后疗效比较。结果48例一期完成手术,其中22例斜卧位B超下,3例斜卧位C臂机下,11例俯卧位B超下,12例俯卧位C臂机下。4例俯卧位C臂机下,穿刺失败,其中2例二期原通道完成手术,2例穿刺中大出血中转开放取石。手术时间1.0～3.5h,平均1.8h;出血量50～600ml,平均190ml。结石清除率98%。没有术中肠道、肝、脾损伤及胸膜损伤、术后继发出血等并发症。结论经皮肾镜斜卧位及B超定位下穿刺合用安全可行,成功率高,操作简便、舒适,可作首选体位及穿刺设备选择。
Objective To evaluate the position of percutaneous nephrolithotomy and the selection and curative effect of guiding equipment. Methods Retrospective analysis of our hospital from October 2006 to November 2007, 52 cases of upper urinary calculi and stenosis percutaneous nephrolithotomy. Select prone position, oblique position in the C arm machine and B ultra-positioning puncture, postoperative efficacy comparison. Results Of the 48 patients who underwent surgery in the first phase, 22 were under-lying in the supine position, 3 under the C-arm in the prone position, and 11 under the prone position in the prone position. Four cases of prone C-arm machine, the puncture failure, of which two cases of the original channel to complete the operation, two cases of puncture bleeding in the transfer open stone. Surgery time 1.0 ~ 3.5h, an average of 1.8h; bleeding 50 ~ 600ml, an average of 190ml. Stone clearance rate of 98%. No intraoperative intestinal, liver and spleen injury and pleural injury, postoperative complications such as hemorrhage. Conclusion Percutaneous nephrolithotomy and transpedicular positioning B safe and feasible, high success rate, easy to operate, comfortable, can be the preferred choice of position and puncture equipment.