经皮肾穿刺在肾镜取石术中的应用及创新

黄苏溪, 海拉提, 孙丙华, 艾孜买提, 何霞

武警医学 ›› 2025, Vol. 36 ›› Issue (9) : 803-809.

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武警医学 ›› 2025, Vol. 36 ›› Issue (9) : 803-809.
综述

经皮肾穿刺在肾镜取石术中的应用及创新

  • 黄苏溪, 海拉提, 孙丙华, 艾孜买提, 何霞
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文章历史 +

摘要

经皮肾镜取石术(PCNL)是上尿路结石的重要治疗方法之一,其中经皮肾穿刺是肾镜取石术的最关键步骤。目前,B超和X射线是PCNL临床最常用的穿刺定位手段 ,但临床应用发现,精准性较差。随着科技的进步及人工智能时代的到来,各种新技术和新设备不断涌现,特别是多学科交叉融合理论、技术创新性的应用在 PCNL中,使得经皮肾穿刺技术飞速发展,涌现出多种精准穿刺定位系统和技术。本文对经皮肾穿刺在肾镜取石术中的应用及创新进行综述,对充分发挥多学科交叉融合的作用提供帮助。

关键词

学科交叉 / 经皮肾镜碎石术 / 穿刺 / 超声 / 透视

引用本文

导出引用
黄苏溪, 海拉提, 孙丙华, 艾孜买提, 何霞. 经皮肾穿刺在肾镜取石术中的应用及创新[J]. 武警医学. 2025, 36(9): 803-809
中图分类号: R692.1   

参考文献

[1] 黄 健, 王建业, 李 虹, 等. 中国泌尿外科和男科疾病诊断治疗指南[M], 2019 版, 北京: 科学出版社, 2020:246.
[2] Andonian S, Scoffone C M, Louie M K, et al. Does imaging modality used for percutaneous renal access make a difference? A matched case analysise[J]. J Endourol, 2013, 27(1):24-28.
[3] 李建兴, 肖 博, 唐宇哲, 等. 融合影像技术在超声定位经皮肾镜手术中的初步应用. 中华泌尿外科杂志, 2017, 38(9):658-661.
[4] Miller N L, Matlaga B R, Lingeman J E. Techniques for fluoroscopic percutaneous renal access[J]. J Urol, 2007, 178(1):15-23.
[5] Smith D L, Heldt J P, Richards G D, et al. Radiation exposure during continuous and pulsed fluoroscopy[J]. J Endourol, 2013, 27(3):384-388.
[6] Cadeddu J A, Stoianovici D, Chen R N, et al. Stereotactic mechanical percutaneous renal access[J]. J Endourol, 1998, 12(2):121-125.
[7] Mon M O, Ramesh H G, Kiantai C, et al. Automated needle targeting with x-ray (ANT-X)-Robot-assisted device for percutaneous nephrolithotomy (PCNL) with its first successful use in human[J]. J Endourol, 2018, 35(6):e919.
[8] Cadeddu J A, Stoianovici D, Chen R N, et al. Stereotactic mechanical percutaneous renal access[J]. J Endourol, 1998, 12(2):121-125.
[9] Taguchi K, Hamamoto S, Okada A, et al, Robotassisted fluoroscopy versus ultrasound-guided renal access for nephrolithotomy:a phantom model benchtop study[J]. J Endourol, 2019, 33(12):987-994.
[10] Su L M, Stoianovici D, Jarrett T W, et al. Robotic percutaneous access to the kidney:comparison with standard manual access[J]. J Endourol, 2002, 16(7):471-475.
[11] Lawson R K, Murphy J B, Taylor A J, et al. Retrograde method for percutaneous access to kidney[J]. Urol, 1983, 22(6):580-582.
[12] Kawahara T, Ito H, Terao H, et al. Ureteroscopy assisted retrograde nephrostomy:a new technique for percutaneous nephrolithotomy (PCNL)[J]. BJU Int, 2012, 110(4):588-590.
[13] Wynberg J B, Borin J F, Vicena J Z, et al, Flexible ureteroscopy-directed retrograde nephrostomy forpercutaneous nephrolithotomy:description of a technique[J]. J Endourol, 2012, 26(10):1268-1274.
[14] Khan F, Borin J F, Pearle M S, et al. Endoscopically guided percutaneous renal access:“seeing is believing”[J]. J Endourol, 2006, 20(7):451-455[discussion:455].
[15] Alsyouf M, Arenas J L, Smith J C, et al. Direct endoscopic visualization combined with ultrasound guided access during percutaneous nephrolithotomy:a feasibility study and comparison to a conventional cohort[J]. J Urol, 2016, 196(1):227-233.
[16] Kidd C F, Conlin M J. Ureteroscopically assisted percutaneous renal access[J]. Urol, 2003, 61(6):1244-1245.
[17] Grasso M, Lang G, Taylor F C. Flexible ureteroscopically assisted percutaneous renal access[J]. Tech Urol, 1995, 1(1):39-43.
[18] Isac W, Rizkala E, Liu X, et al. Endoscopic-guided versus fluoroscopic-guided renal access for percutaneous nephrolithotomy:a comparative analysis[J]. Urol, 2013, 81(2):251-256.
[19] 高 新, 周 铁, 萧翠兰, 等. 单用B超引导建立经皮肾穿刺通道行经皮肾镜取石术 (附 102 例报告 )[J]. 临床泌尿外科杂志, 2003, 18(1):10-12.
[20] 潘金生, 熊朝晖, 赵本隆, 等. 超声引导下经皮肾镜取石术标准通道与多通道的效果比较[J]. 武警医学, 2023, 34(6):469-471.
[21] Krueger P M, Colema K, Rooks R N. Race/ethnicity, nativity and trends in BMI among USadults[J]. Obesity (Silver Spring), 2014, 22(7):1739-1746.
[22] Lojanapiwat B. The ideal puncture approach for PCNL:fluoroscopy, ultrasound or endoscopy?[J]. Indian J Urol, 2013, 29(3):208-213.
[23] Chi Q, Wang Y, Lu J, et al. Ultrasonography combined with fluoroscopy for percutaneous nephrolithotomy:an analysis based on seven years single center experiences[J]. Urol J, 2014, 11(1):1216-1221.
[24] 李永发, 阮安明, 杨钧显, 等. “刚柔精准穿刺法”在超声引导经皮肾镜术中的应用[J/CD]. 中华腔镜泌尿外科杂志(电子版 ), 2018, 12(1):8-12.
[25] 姚爱兵, 蒋 齐, 卫中庆, 等. 腔内超声造影技术在无明显肾积水肾结石经皮肾镜手术中的应用[J]. 东南国防医药, 2019, 21(2):152-155.
[26] Thomas A, Ewald J, Kelly I, et al. Conventional vs computer-assisted stereoscopic ultrasound needle guidance for renal access:a randomized crossover bench-top trial[J]. J Endourol, 2018, 32(5):424-430.
[27] Li R, Li T, Qian X, et al. Real time ultrasonography-guided percutaneous nephrolithotomy using sonixgps navigation:clinical experience and practice in a single center in China[J]. J Endourol, 2015, 29(2):158-161.
[28] Li X, Long Q, Chen X, et al. Real-time ultrasoundguided PCNL using a novel SonixGPS needle tracking system[J]. Urolithiasis, 2015, 29(2):158-161.
[29] 庄浩铨, 徐煜宇, 徐桂彬. 经皮肾精准穿刺技术相关进展[J]. 现代泌尿外科杂志, 2022, 27(2):168-172.
[30] Bader M J, Gratzke C, Seitz M, et al. The “all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy[J]. Eur Urol, 2011, 59(6):1054-1059.
[31] Jiang K, Chen H, Yu X, et al. The“all seeing needle”micro-PCNL versus flexible ureterorenoscopy for lower calyceal stones of ≤ 2 cm[J]. Urolithiasis, 2019, 47(2):201-206.
[32] Kaynar M, Su M, Er A, et al. Micr-opercutaneous nephrolithotomy (microperc ) in a two year old with the“all-seeing needle”[J]. Urol Int, 2013, 91(2):239-241.
[33] 李四化, 范翰共, 刘 聪. B超联合C型臂X光机在经皮肾镜碎石术中建立经皮肾镜工作通道的临床应用[J]. 中国医学创新, 2017, 14(22):21-25.
[34] 刘光香, 费夏玮, 张士伟, 等. X线联合B超定位下微创经皮肾镜碎石术治疗复杂性肾结石286例分析[J]. 现代泌尿外科杂志, 2015, 20(1):18-20.
[35] 李立俊, 李康土, 林贤鸿. 术前CT指导通道设计结合术中B超、X射线实时定位在经皮肾镜取石术中建立工作通道的临床应用价值[J]. 影像研究与医学应用, 2021, 5(14):223-224.
[36] Mozer P, Conort P, Leroy A, et al. Aid to percutaneous renal access by virtual projection of the ultrasound puncture tract onto fluoroscopic images[J]. J Endourol, 2007, 21(5):460-465.
[37] Khater N, Shen J, Arenas J, et al. Bench-top feasibility testing of a novel percutaneous renal access technique:the laser direct alignment radiation reduction technique (DARRT)[J]. J Endourol, 2016, 30(11):1155-1160.
[38] Olgin G, Smith D, Alsyouf M, et al. Ureteroscopy without fluoroscopy:a feasibility study and comparison with conventional ureteroscopy[J]. J Endourol, 2015, 29(6):625-629.
[39] Lima E, Rodrigues P L, Mota P, et al. Ureteroscopy-assisted percutaneous kidney access made easy:first clinical experience with a novel navigation system using electromagnetic guidance (IDEAL Stage 1)[J]. Eur Urol, 2017, 72(4):610-616.
[40] Rodrigues P L, Rodrigues N F, Fonseca J, et al. Kidney targeting and puncturing during percutaneous nephrolithotomy:recent advances and future perspectives[J]. J Endourol, 2013, 27(7):826-834.
[41] Jiao D, Zhang Z, Sun Z, et al. Percutaneous nephrolithotripsy:C-arm CT with 3D virtual navigation in non-dilated renal collecting systems[J]. Diagn Interv Radiol, 2018, 24(1):17-22.
[42] Mozer P, Conort P, Leroy A. Aid to percutaneous renal access by virtual rojection of the ultrasound puncture tract onto fluoroscopic images[J]. J Endourol, 2007, 21(5):460-465.
[43] Murat A, Ahmet B, Sema S, et al. A hypothetical method for calculation of the access point, direction angle and access angle for percutaneous nephrolithotomy[J]. Medical Hypotheses 124 (2019) 101-104.
[44] 赖锦源, 卢凯鑫, 刘昌毅, 等. 肾脏 incool-3D 立体影像技术在复杂肾结石经皮肾镜碎石取石术中的应用:前瞻性随机对照研究[J]. 中国微创外科杂志, 2021, 21(9):776-781.
[45] 吴清国, 覃 斌, 梁毅文, 等. 2023-3D 打印技术在经皮肾镜碎石术治疗复杂性肾结石中的应用:前瞻性随机对照研究[J]. 中国微创外科杂志, 2023, 23(6):430-435.
[46] Rassweiler M C, Rassweiler J J, Weiss C, et al. iPad-assisted percutaneous nephrolithotomy (PCNL):amatched pair analysis compared to standard PCNL[J]. World J Urol, 2020, 38(2):447-453.
[47] 刘宇保, 宋海峰, 王碧霄, 等. 人工智能混合现实技术在特殊类型复杂性上尿路结石经皮肾镜手术规划中的应用[J]. 现代泌尿外科杂志, 2024, (29)7:586-592.

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