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目的评价超声引导在微创经皮肾镜取石术治疗肾结石和输尿管上段结石中的应用价值。方法451例肾或输尿管上段结石患者,采用超声引导定位下肾穿刺,建立皮肾通道;碎石取石过程中超声监测有无结石残留并指导碎石取石;必要时超声引导下建立多个皮肾通道取石。结果450例患者在超声引导下成功建立了皮肾通道,1例超声引导穿刺失败。超声引导下穿刺成功率为99.8%(450/451),其中402例患者经超声引导一次性穿刺成功,48例患者两次穿刺成功;82例患者超声引导下建立多个皮肾通道。结论微创经皮肾镜取石术采用超声引导定位穿刺建立皮肾通道,具有定位准确、安全、可重复、简便易行及避免放射线损伤等优点,可作为经皮肾镜引导穿刺的首选方法。
Objective To evaluate the value of ultrasonography in the treatment of renal calculi and upper ureteral calculi in minimally invasive percutaneous nephrolithotomy. Methods 451 cases of renal or upper ureteral stones in patients with ultrasound-guided positioning of the renal puncture, the establishment of the renal access; gravel in the stone during the ultrasound monitoring of residual stones and guide the gravel stone; if necessary, under the guidance of ultrasound to establish multiple skin and kidney Channel stone. Results 450 patients under the guidance of ultrasound successfully established a renal tunnel, 1 case of ultrasound-guided puncture failure. The success rate of ultrasound-guided puncture was 99.8% (450/451). One hundred and two punctures were successfully performed in 402 patients and two puncture in 48 patients. 82 patients under ultrasound guidance established multiple renal access. Conclusion Minimally invasive percutaneous nephrolithotomy using ultrasound guided positioning puncture to establish the renal access, with accurate positioning, safe, repeatable, simple and easy to avoid radiation damage and other advantages, can be used as the preferred method of percutaneous nephrolithotomy.