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目的探讨在经皮肾镜取石术中应用X线斜向辅助定位法建立经皮肾通道的可行性。方法甲组101例,采用X线斜向辅助定位法建立经皮肾通道,乙组95例采用常规X线穿刺定位法,比较两组建立通道所需穿刺次数、穿刺时间及安全性上的差异。结果甲组平均穿刺次数2.1次,乙组4.1次;甲组平均穿刺时间4.5min,乙组12.4min;两者均相差显著(P<0.01)。甲组无大出血、肾盂穿孔,乙组2例出现肾盂穿孔,3例因穿刺导致严重出血终止手术或改开放手术。结论经皮肾镜取石术中应用X线斜向辅助定位法可快速确定经皮肾穿刺的角度和深度,简明、安全、易掌握,并适用于有开放手术史、肾脏旋转不良等情况下的穿刺。
Objective To explore the feasibility of percutaneous nephrolithotomy using X-ray oblique positioning method to establish percutaneous renal access. Methods A group of 101 cases, the use of X-ray oblique positioning method to establish percutaneous renal access, 95 cases of group B using conventional X-ray location method, the two groups required to establish the passage of the number of punctures, puncture time and safety differences . Results The average number of puncture in group A was 2.1 times and in group B 4.1 times. The average puncture time in group A was 4.5 minutes and that in group B was 12.4 minutes. There was a significant difference between the two groups (P <0.01). Group A no major bleeding, peritoneal perforation, B group 2 cases of peritoneal perforation, 3 cases of puncture led to severe bleeding termination of surgery or change to open surgery. Conclusion Percutaneous nephrolithotomy using X-ray oblique auxiliary positioning method can quickly determine the angle and depth of percutaneous renal biopsy, concise, safe and easy to grasp, and is suitable for open surgery history, poor kidney rotation, etc. puncture.