| 摘要: |
| 目的 探讨三明治式球囊扩张术在完全B超引导的经皮肾镜手术应用的可行性和安全性。方法 超声引导下用带有刻度的18G穿刺针穿刺目标肾盏,确定经皮肾通道的长度。用记号笔标记经皮肾球囊使得尖部至标记处长度等于经皮肾通道长度。三明治式球囊扩张方法：沿斑马导丝顺行放置球囊至标记处,在超声监视下扩张球囊,压力为20atm持续时间5分钟；20.8F 肾镜和EMS超声用于碎石,碎石结束后再次用球囊扩张压迫通道5分钟(20atm)。结果 2014年6月至2014年10月,共完成56手术,患者平均年龄53岁,其中男性32例,女性21例。肾结石大小为2.4±0.4cm。BMI为23.1±2.8。平均住院天数7天。患者术前后血红蛋白分别为14.1±2.1g/dl和13.3±2.1g/dl; 患者术前后红细胞压积分别为40.7±5.3% 和 38.1±5.1%。没有患者需要输血、DAS栓塞止血以及其它严重并发症。结论 球囊扩张使得完全B超引导的经皮肾镜手术变得容易简单,三明治式球囊扩张可进一步减少肾脏出血并发症。 |
| 关键词: 球囊扩张术 肾结石 经皮肾镜取石术 |
| DOI：10.3724/SP.J.1008.2015.00925 |
| 投稿时间：2015-03-09修订日期：2015-04-30 |
| 基金项目:上海市卫生局局级科研项目(2010173). |
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| Application of Sandwich balloon dilation for total ultrasound guided-percutaneous nephrolithotomy |
| FANG Liang1Δ,XU Wei-ming2Δ,CHEN Guang-hua3,XIAO Guang-an3*,ZHOU Tie3* |
(1. Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Urology, People's Hospital of Haining, Branch of Changhai Hospital, Second Military Medical University, Haining 314400, Zhejiang, China;
3. Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
△Co-first authors
*Corresponding authors) |
| Abstract: |
| Objective To investigate the feasibility and safety of Sandwich Balloon Dilation for totally ultrasound guided percutaneous nephrolithotomy (PCNL) . Methods An 18G needle with length marker was used to puncture the target calyx under the guidance of ultrasound and the depth of percutaneous tract was defined. Then the length of balloon similar to tract depth was marked by marker pen. Sandwich Balloon Dilation: Balloon was indwelled along the zebra guidewire until the marker, and inflated with 20atm for 5 minutes; 20.8F renoscope combined with EMS lithotripsy were used for fragmentation; finally before the end of surgery balloon was used again to tamponade the percutaneous tract. Results Between June 2014 and October 2014, a total of 56 patients (32 males and 21 females) with the average age of 53y underwent PCNL. The average stone size was 2.4±0.4cm; BMI23.1±2.8 and hospitalization 7 days. The average hemoglobin and hematocrit before and after operation was 14.1±2.1 vs 13.3±2.1g/dl and 40.7±5.3% vs 38.1±5.1%, respectively. No patient needed transfusion or embolization. No other severe complications happened. Conclusion Balloon dilation makes totally ultrasound PCNL easy and safe; while Sandwich Balloon Dilation further decreases haemorrhage complication. |
| Key words: balloon dilation kidney calculi percutaneous nephrolithotomy |
