山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (10): 46-50.doi: 10.6040/j.issn.1671-7554.0.2023.0827
张英晨1,赵帅1,孙浩1,毕文浩1,吴志强1,成小建1,蒋立城2
ZHANG Yingchen1, ZHAO Shuai1, SUN Hao1, BI Wenhao1, WU Zhiqiang1, CHENG Xiaojian1, JIANG Licheng2
摘要: 目的 探讨局麻下非同步CT辅助联合超声定位微创经皮肾镜取石术治疗上尿路结石的应用价值。 方法 对244例259侧上尿路结石患者术前模拟术中体位行CT扫描辅助定位,术中根据CT影像信息联合超声定位穿刺在局麻下行微创经皮肾镜取石术,观察患者术中疼痛视觉模拟评分(VAS)、结石取净率和手术并发症。 结果 术中局部麻醉效果满意,所有患者均在局麻下完成手术。疼痛评分1~3分112例(45.9%),4~6分117例(48.0%),7~9分15例(6.1%)。所有患者均成功建立经皮肾穿刺通道,手术时间40~160 min,平均92 min。患者总结石取净率为88.8%(230/259),其中输尿管上段结石为98.1%(102/104),单发肾结石93.9%(62/66),复杂性肾结石74.2%(66/89)。术后活动性出血2例,未发现肝脾、肠管、胸腔损伤等严重并发症。住院时间5~15 d,平均8.6 d。 结论 局麻下非同步CT辅助联合超声定位行微创经皮肾镜取石术简单、安全、高效、经济,值得临床推广应用。
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