SonixGPS影像穿刺定位在脊柱畸形伴上尿路结石中的临床应用(1)

http://www.100md.com 2017年10月8日 《中国医药科学》 2017年第9期

     [摘要] 目的 探討SonixGPS影像穿刺定位系统在经皮肾镜治疗脊柱畸形伴上尿路结石患者的安全性及有效性。方法 从2014年1月～2016年1月，我院共收集脊柱畸形伴上尿路结石患者60例，男35例，女25例，平均年龄57.3 (44～77)岁。所有患者均经B超、KUB、CT检查确诊为脊柱畸形伴上尿路结石。按照穿刺方法将患者随机分为SonixGPS影像穿刺和B超定位穿刺法，比较并分析两组穿刺方法对患者术后血液动力学变化和肾功能的变化。结果 SonixGPS影像穿刺组患者均一次穿刺成功并行一期碎石，手术时间35～120min，平均55min，经皮肾穿刺时间2～15min，平均6min。术中术后未出现大出血、肠道损伤、气胸等并发症。SonixGPS影像穿刺组的患者碎石后，血液动力学变化如血红蛋白、红细胞压积和血氧饱和度以及术后肾功能的变化均优于常规B超定位穿刺组，两组间差异具有统计学意义(P<0.05)。结论 SonixGPS影像穿刺定位系统可精准地看到穿刺针在组织中的穿刺轨迹，缩短了术中穿刺的时间。与常规B超穿刺法相比，脊柱畸形伴上尿路结石患者采用SonixGPS影像穿刺法降低了术后并发症的发生，值得在临床推广应用。

    [关键词] 脊柱畸形；肾结石；经皮肾镜取石术；超声引导

    [中图分类号] R693 [文献标识码] A [文章编号] 2095-0616(2017)09-20-05

    Clinical application of SonixGPS image puncture location in spinal deformity accompanied by upper urinary calculi

    LU Suilin QI Defeng LIU Guanzhao ZENG Guohua

    Department of Urinary Surgery， the First Affiliated Hospital of Guangzhou Medical University，Key Laboratory of Department of Urinary Surgery， Institute of Department of Urinary Surgery， Guangzhou 510120， China

    [Abstract] Objective To explore the safety and effectiveness of SonixGPS image puncture location system in treatment of patients with spinal deformity accompanied by upper urinary calculi under percutaneous nephroscope. Methods 60 patients with spinal deformity accompanied by upper urinary calculi from January 2014 to January 2016 in our hospital were collected. Of whom， there were 35 male cases and 25 female cases， with the average age of 57.3(44-77). All patients were diagnosed as spinal deformity accompanied by upper urinary calculi by B ultrasound， KUB and CT. Patients were randomly divided into the SonixGPS image puncture and B ultrasound located puncture method according to puncture methods. Effects of puncture methods on postoperative hemodynamics and renal function of patients were compared and analyzed. Results Patients in the SonixGPS image puncture group were punctured successfully in one time and underwent one stage lithotripsy. Operative time was ranging from 35 to 120 mins and the average time was 55 mins. Time of percutaneous renal puncture was ranging from 2 to 15 mins and the average time was 6 mins. No complication such as massive hemorrhage， intestinal injury and pneumothorax occurred in and after operation. After lithotripsy， hemodynamic changes of patients in SonixGPS image puncture group such as hemoglobin， hematocrit， blood oxygen saturation and postoperative renal function were all better than those of the B ultrasound located puncture group. There were significant differences between two groups(P<0.05). Conclusion SonixGPS image puncture location system can precisely see puncture tracks of puncture needles and shorten intraoperative puncture time. Compared with routine B ultrasound puncture method， application of SonixGPS image puncture location in patients with spinal deformity accompanied by upper urinary calculi can reduce the occurrence of postoperative complications， which is worthy of clinical promotion and application.(卢穗琳?戚德峰?刘冠炤?曾国华)

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