多层螺旋CT三维成像在经皮肾镜取石术中的应用价值

Clinical evaluation of three dimensional spiral CT reconstruction in percutaneous nephrolithotomy

目的探讨多层螺旋CT三维成像技术在经皮肾镜取石术中的应用价值。方法2005年1月至2007年11月收治。结果21例手术均获成功,无其他脏器损伤、大出血、感染、尿漏等并发症。实验组手术时间(76±38)min,术中出血量(94±53)ml,结石残留率为5.8%,对照组手术时间(125±46)min,术中出血量(106±47)ml,结石残留率为17.6%。两组术中出血量无明显差异(P>0.05),手术时间、结石残留实验组明显低于对照组(P<0.05)。结论螺旋CT三维成像技术立体的显示了结石及周围结构关系,在PCNL术前确定穿刺部位、穿刺通道数目方面有重要的临床价值。

Objective To evaluate the utility of spiral computed tomography （CT） with three-dimensional （3D） reconstruction for preoperative planning of percutaneous nephrolithotomy （PCNL） in patients with complex kidney calculi. Methods 21 patients with complex renal calculi was hospitalized from January 2005 to November 2007. Preoperative Spiral CT were performed in all patients. Reconstruction techniques of three dimension were adopted. Percutaneous nephrolithotomy combined pneumatic and ultrasound lithotripsy was performed under ultrasound guidance in the test group. 94 patients didn＇t undergo spiral CT examination as the control group.Remits All procedures were successful, no complications such as hemorrhage,inflation,urine leakage occurred after operation.The operative time of the test group was 76± 38 min, the intra-operative blood loss was 94±53 ml, and the rate of remaining calculi was 5.8 %. However, the operative time of the control group was 125±46 min, the intra-operative blood loss was 106 ± 47 ml , and the rate of remaining calculi was 17.6 % . The intra-operative blood loss had no significant differences between the two groups （P 〉0.05）, but the operative time and the rate of remaining calculi of the test group were significantly lower than that of the control group （P〈 0.05） . Conclusions Reconstructive techniques of three dimensional spiral CT can depict the relationship between the calculi and its surrounding organs and it has great application value in the process of Percutaneous Nephrolithotomy.