探讨超声造影引导在经皮肾镜碎石取石术（PCNL）中工作微通道建立的临床应用价值。

选取河池市宜州区人民医院2019年7月至2021年1月收治的60例无肾积水或者轻度肾积水的肾结石或输尿管上段结石患者作为研究对象，根据手术方式及临床资料匹配分成观察组（超声造影引导经皮肾镜碎石取石工作通道建立）及对照组（普通超声引导经皮肾镜碎石取石工作通道建立），两组均在超声定位下徒手进行目标肾盏穿刺，使用一次性微创扩张引流套件进行经皮肾盏扩张，放置一次性剥皮鞘，详细记录两组患者手术过程中穿刺针数、穿刺时间、手术时间、术中出血量和手术前后血红蛋白量、感染率，肾周围器官是否有损伤，肾造瘘管是否有尿漏这几方面数据。

观察组和对照组对比穿刺次数及穿刺时间差异有统计学意义（P<0.05），手术时间、术中出血量和手术前后血红蛋白量、感染率，肾周围器官是否有损伤，肾造瘘管是否有尿漏差异无统计学意义（P>0.05）。

超声造影剂逆行肾盂造影可改善PCNL术中肾集合系统显像情况，使术者能更快更准确地进行目标盏组穿刺，更有利于经皮肾穿刺建立工作通道，使PCNL更安全、有效，减少手术并发症，降低手术风险，值得为临床提供借鉴参考。

To investigate the clinical value of contrast-enhanced ultrasound-guided microchannel establishment in percutaneous nephrolithotomy (PCNL).

Sixty patients with renal calculi or upper ureteral calculi without hydronephrosis or mild hydronephrosis admitted to People's Hospital of Yizhou District from July 2019 to January 2021 were selected as the study subjects and matched according to surgical methods and clinical data and divided into the observation group (contrast-enhanced ultrasound-guided PCNL) and the control group (common ultrasound-guided PCNL). Both groups underwent target calyceal puncture by hand under ultrasound guidance, percutaneous calyceal dilatation was performed using a disposable minimally invasive dilatation and drainage kit, and a disposable skin sheath was placed. The number of puncture needles, puncture time, operation time, intraoperative blood loss and preoperative and postoperative hemoglobin volume, infection rate, whether the perirenal organs were injured, and whether the nephrostomy tube had urinary leakage were recorded in detail.

There were significant differences in puncture times and puncture time between the observation group and the control group (P<0.05). There was no significant difference in operation time, intraoperative blood loss, hemoglobin volume before and after operation, infection rate, complications such as perirenal organ injury and nephrostomy tube urine leakage (P>0.05).

Retrograde pyelography with ultrasound contrast agent can improve the imaging of renal collecting system during PCNL, which allows the surgeon to perform puncture more quickly and accurately, and make PCNL safer and more effective, with fewer complications. It is worthy for clinical practice.