CAJ | 학술논문

目的：探讨应用B超引导“改良一步法”建立标准通道在经皮肾镜碎石术中应用的安全性和可行性。方法：2013年4月至2014年10月我科应用B超引导“改良一步法”建立标准通道进行经皮肾镜碎石术患者共131例，对其通道建立过程及临床结果进行回顾性分析。结果：131例患者通过“改良一步法”均成功建立通道，共建立皮肾通道149个，一期单通道122侧，一期双通道8侧，一期三通道2侧，一期四通道1侧，二期新建通道1侧，平均单个通道建立时间为（6.36±1.04）min。通道建立过程中，扩张过深5例，致上尿路穿孔3例和对侧肾实质损伤2例。无术中术后严重出血、邻近脏器损伤发生。结论：超声引导下“改良一步法”建立标准皮肾通道技术具有安全、可行、简便的优点，值得临床推广应用。
목적：탐토응용B초인도“개량일보법”건립표준통도재경피신경쇄석술중응용적안전성화가행성。방법：2013년4월지2014년10월아과응용B초인도“개량일보법”건립표준통도진행경피신경쇄석술환자공131례，대기통도건립과정급림상결과진행회고성분석。결과：131례환자통과“개량일보법”균성공건립통도，공건립피신통도149개，일기단통도122측，일기쌍통도8측，일기삼통도2측，일기사통도1측，이기신건통도1측，평균단개통도건립시간위（6.36±1.04）min。통도건립과정중，확장과심5례，치상뇨로천공3례화대측신실질손상2례。무술중술후엄중출혈、린근장기손상발생。결론：초성인도하“개량일보법”건립표준피신통도기술구유안전、가행、간편적우점，치득림상추엄응용。
Objective: To investigate the safety and efifcacy of establishing standard percutaneous renal channel using ultrasound-guided “improved one-step method”.Methods: A total of 131 patients with urinary calculi underwent percutaneous nephroscope lithotripsy using ultrasound-guided “improved one-step method” to establish standard percutaneous renal channel in our department from April 2013 to July 2014. The operation pro-cess and results of 131 cases were now retrospectively analyzed.Results: Channel in one hundred and thirty-one patients through the “improved one-step” was success fully established, I period of single-channel was establis-bed in 122 cases, dual-channel in 8 cases, three-channel in 3 cases and II stage of new channel in 1 case, the time for setting up a single channel was 6 minutes on average. In the process of establishing channel, expanded too deep in 5 cases, including the upper urinary tract perforation in 3 cases and contralateral renal parenchyma injury in 2 cases. None of the patients suffered from severe loss of blood or destruction of adjacent organs during intra-operative or postoperative.Conclusion: As a technology of establishing standard percutaneous renal channel, it is safe and convenient and effective, which is worth of clinical promotion.