Clinical Application Of Minimally Invasive Percutaneous Nephrolithotomy With Ultrasound Guidance For Treatment Of Upper Urinary Calculi

Objective:To evaluate the clinical effect and explore the value of treatment of upper urinary calculi with minimally invasive percutaneous nephrolithotomy under the guidance by B-ultrasound.Methods:Review and analyse the clinical data of 120 patients,60 patients of them underwent MPCNL by ultrasound guidance ,the other underwent open operation.Double J stents were used in all cases .All of the patients were followed up 1—3months.Results:MPCNL group:They were treated with one-stage and single tract .The stone clearance rate was 88.33%(53/60);the average operative duration was 80±10.5minutes(40—210min);the mean hospital stay was 5.8±1.2d(5—15d);the mean volume of bleeding was 100ml(30—600ml) during operation,1 case with blood transfusion(1.66%);1 case was complicated with severe bleeding after procedure and with blood transfusion and changed into open surgery(1.66%);39 cases were fever after operation (65.0%) and 5 cases of them T﹥38.5℃(8.33%);the average time of blood urine was 2.8±1.1d(2—5d) .Opened group:The stone clearance rate was 71.66%(43/60);the mean operative duration was 105±11.6 minutes(70—190min);the average hospital stay was 17.5±1.1d(9—32d);the average volume of bleeding was 350ml (150—800ml) during operation ,11 cases with blood transfusion(18.33%),8 cases were complicated with severe bleeding after operation and with blood transfusionh(13.33%);55 cases were fever after operation(91.66%) and 24 cases of them T>38.5℃(40.0%);the average time of blood urine was 8.6±1.3d(4—13d) ; 9 cases were poor wound healing after operation(15.0%);6cases were urine leakage after operation(10.0%).Conclusions:Less trauma,high success rate ,safe and less complications are the merits of MPCNL with ultrasound guidance .It is an ideal method in the treatment of calculus in upper urinary and worthwhile to be widely used in clinical.