非同步俯卧位螺旋CT辅助定位行微创经皮肾镜取石的可行性研究

The Feasibility Study of Non-synchronous Assistant Localization in Prostrate Position by Spiral CT Scan in Minimally Invasive Percutaneous Nephrolithotomy

目的:探讨非同步俯卧位螺旋CT定位行微创经皮肾镜取石的可行性。方法:对5例肾结石和4例输尿管上段结石共9例拟行微创经皮肾镜取石患者,术前两次行俯卧位螺旋CT扫描,分别测量皮肤标记穿刺点到结石及肾下极的层面距离、标记穿刺点到达肾收集系统的深度以及穿刺径路与背部平面(人体冠状面)的角度并进行统计学分析。结果:两次扫描测得的穿刺点到结石及肾下极距离差值分别是(0.56±0.77)mm(P=0.49)和(1.11±1.54)mm(P=0.06),穿刺深度及角度差值分别为(0.18±0.85)mm(P=0.84)和(-0.64°±0.55°)(P=0.27)。结论:非同步俯卧位螺旋CT定位行微创经皮肾镜取石切实可行。

Objective：To investigate the feasibility of non-synchronous assistant localization in prostrate position by spiral CT scan in minimally invasive percutaneous nephrolithotomy. Methods：Upper ureteral calculi in 4 cases and renal calculi in 5 cases, which would be treated by minimally invasive percutaneous nephrolithotomy. They were given spiral CT scan twice in two separate prostrate states early or late. The distances from the marked puncture spot to the calculi and to the lower renal pole were measured in advance, simultaneously with the deep from the marked puncture spot to renal collecting system, and the angle of puncture approach and the back plane （the human coronal plane）. The data were analyzed statistically. Results; The difference of the two times measure of distances from the marked puncture spot to the stone and the lower renal pole were （0. 56±0.77） mm（P=0.49） and （1.11±1. 54） mm（P=0.06）, with （0.18±0.85） mm （P=0.84） and （-0.64°±0.55°） （P= 0. 27） of the deep and the angle of puncture. Conclusions： Non-synchronous assistant localization in prostrate position by spiral CT scan is true feasible for accurate puncture in minimally invasive percutaneous nephrolithotomy.