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[1]姚爱兵,蒋齐,卫中庆,等.腔内超声造影技术在无明显肾积水肾结石经皮肾镜手术中的应用[J].医学研究与战创伤救治(原医学研究生学报),2019,21(02):152-155.[doi:10.3969/j.issn.1672-271X.2019.02.008]
　YAOAi-bing,JIANGQi,WEIZhong-qing,et al.The clinical study of intracavitary ultrasound imaging in the application of percutaneous nephrolithotomy without hydrocalycosis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(02):152-155.[doi:10.3969/j.issn.1672-271X.2019.02.008]
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腔内超声造影技术在无明显肾积水肾结石经皮肾镜手术中的应用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年02期
页码:
152-155
栏目:
临床研究
出版日期:
2019-03-20

文章信息/Info

Title:
The clinical study of intracavitary ultrasound imaging in the application of percutaneous nephrolithotomy without hydrocalycosis
作者:
姚爱兵; 蒋齐; 卫中庆; 孟旭辉; 张丽娟; 葛京平
作者单位：210031 南京，南京医科大学第四附属医院（浦口医院）泌尿外科（姚爱兵、蒋 齐、张丽娟）；210000 南京，南京医科大学第二附属医院泌尿外科（卫中庆、孟旭辉）；210002 南京，东部战区总医院（原南京军区南京总医院）泌尿外科（葛京平）
Author(s):
YAO　Ai-bing1;  JIANG　Qi1;  WEI　Zhong-qing2;  MENG　Xu-hui2;  ZHANG　Li-juan1;  GE　Jing-ping3
（1.Department of Urology Surgery，Nanjing Medical University Fourth Affiliated Hospital/Pukou Hospital，Nanjing 210031，Jiangsu，China； 2.Department of Urology Surgery，Nanjing Medical University Second Affiliated Hospital，Nanjing 210000，Jiangsu，China；3.Depart
关键词:
肾积水; 肾结石; 经皮肾镜取石术; 超声造影剂; 针道造影; 逆行造影
Keywords:
hydrocalycosis;  renal calculus;  percutaneous nephrolithotripsy;  acoustic contrast agent;  needle angiography;  retrograde angiography
分类号:
R692.4
DOI:
10.3969/j.issn.1672-271X.2019.02.008
文献标志码:
A
摘要:
目的　探讨腔内超声造影技术在无明显肾积水肾结石微通道经皮肾镜手术（mPCNL）中皮肾通道建立的可行性和安全性。 方法　选取2016年8月至2017年12月南京医科大学第四附属医院44例无明显肾积水肾结石患者，采用随机对照方法将所有患者分为造影组和常规组，每组22例，其中造影组患者行腔内超声造影引导下mPCNL，常规组患者行常规B超引导。比较2组患者目标肾盏穿刺成功率、经皮肾通道建立时间、成功穿刺所用针数及输血率。 结果　造影组在目标肾盏穿刺成功率（100.0% vs 77.3%）、经皮肾通道建立时间[（8.0±2.4）min vs （10.0±3.2）min]及成功穿刺所用针数[（1.2+0.6）针 vs （1.8±1.0）针]均优于常规组(P<0.05)。造影组中无一例因穿刺出血而输血，常规组中2例（9.1%）患者因扩张通道出血过多而术后输血，其中1例术后行数字减影血管造影（DSA）下肾高选择性动脉栓塞止血。 结论　对于无明显肾积水肾结石患者，在mPCNL中采用腔内超声造影技术辅助经皮肾镜通道建立，可提高经目标肾盏穿刺成功率，缩短穿刺所需时间，减少大出血的发生率，是一种安全可行的技术。
Abstract:
Objective　The clinical experience of intracavitary contrast-enhanced ultrasonography in the absence of hydrocalycosis percutaneous nephroscopic surgery was preliminarily summarized.　Methods　44 nephrolith patients were admitted from August 2016 to December 2017.which were divided into two groups according to the form of random grouping，in the ultrasonic contrast group,22 patients underwent intraluminal contrast-enhanced guided minimally invasive percutaneous nephroscope (mPCNL)，and 22 patients underwent ultrasonographically guided mPCNL as normal ultrasound group.The success rate of renal calyceal puncture，the time of channel establishment，the incidence of complications and the rate of blood transfusion were compared.　Results　The ultrasonic contrast group was superior to the normal ultrasound group in the successful rate of renal calyceal puncture（100.0% vs 77.3%），the time of channel establishment[（8.0±2.4）min vs （10.0±3.2）min]，and the number of needles used for successful puncture[（1.2+0.6）needles vs （1.8±1.0）needles] (P<0.05).2 patients（9.1%） had blood transfusions due to excessive bleeding in the dilation channel，and 1 patients underwent renal artery embolization with high selective DSA in hemostasisthe normal ultrasound group.　Conclusion　Intracavitary contrast-enhanced ultrasound is a safe and feasible technique to assist in the absence of hydrocalycosis percutaneous nephroscope and renal puncture and fistula surgery，can improve renal puncture accuracy and success rate in patients without hydrocalycosis by improving the visualization of the renal pelvis.It can shorten the puncture time and reduce the incidence of complications in the establishment of cutaneous renal passage.

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备注/Memo

备注/Memo:
基金项目：基金项目:南京市医学科技发展项目（YKK17261）
更新日期/Last Update: 2019-03-20