关键词: 经皮肾镜取石术；穿刺；刺激性利尿；不逆行输尿管插管, 可行性

Abstract: Objective：To explore the feasibility and effect observation of nonretrograde ureteral catheterization in ultrasound guidedpercutaneous nephrolithotomy.Methods：The clinical data of 42 cases of nonretrograde ureteral  catheterization in ultrasound guided percutaneous nephrolithotomy in our hospital from April 2017 to September 2020 were retrospectively analyzed.None of the 42 patients underwent retrograde ureteral catheterization during surgery.24 patients with moderate to severe hydronephrosis were directly guided by ultrasound to puncture the target renal calyces fornix,and 18 patients with mild hydronephrosis,We were Intravenous infusion of furosemide 40mg for irritating diuresis,about 10 minutes,we to puncture the target renalcalyces fornix,successful established a channel of percutaneous nephrolithotomy.Clinical data includingThe success rate of puncture the target renal calices,nephrostomy tract creation time,overall opration time,reand postoperative hemoglobin value,the tonefree rateand complications were recorded and evaluated.Results：All the 42 patients had successful onetime puncture successfully established skinto renal calyx channels,and performed percutaneous nephrolithotomy.Among mean tract creation time(6.7±1.9)min,overall operation time(46.4±11.5)min,reand postoperative hemoglobin value was(137.0±10.1)g/L and(132.7±12.3)g/L,difference value was(5.6±5.2)g/L,the tonefree rate was 92.8%,no major complications,such as tract loss,massive bleeding,pleura and colon injure and transfusion cases.Conclusions：Outcomes of clinical practice demonstrate that nonretrograde ureteral catheterization in ultrasound guided percutaneous nephrolithotomy is safe and efficacious abaut mild hydronephrosis is by stimulate diuretics and moderate to severe hydronephrosis renal ureteral calculi patients,but it must be accomplished by seasoned doctors and grasp certain ultrasound technology.

Key words: percutaneous nephrolithotomy, puncture, stimulate diuretics, no retrograde ureteral intubation, feasibility