螺旋CT三维重建肾鹿角形结石影像在PCNL术中的应用价值研究

The Value of Three Dimensional Reconstruction CT Image of Staghorn Renal Calculi in Percutaneous Nephrolithotomy

目的:探讨螺旋CT三维重建肾鹿角形结石影像在经皮肾穿刺取石术(PCNL)中的应用价值。方法:将60例肾鹿角形结石患者随机均分成研究组和对照组各30例,利用螺旋CT对全部患者肾鹿角形结石进行非增强薄层扫描,获取结石及肾脏的影像资料,并对研究组的肾鹿角形结石进行三维影像重建。两组均在常规麻醉下行PCNL术,并对手术疗效的一系列指标进行对比研究。结果:60例均顺利完成手术,无明显并发症。研究组手术通道建立时间、术中出血量、一次结石清除率、二次结石清除率等指标均明显优于对照组。结论:螺旋CT三维重建肾鹿角形结石影像可直观、形象、准确地提供结石的立体结构、大小及其所在部位,从而能准确选定经皮肾穿刺的位置,可使PCNL手术入路更精确合理,进而提高碎石取石效率,降低结石残留率,减少手术并发症,有效提高PCNL的疗效。

Objective：To explore the value of three dimensional reconstruction CT image of staghorn renal calculi in percutaneous nephrolithotomy. Methods： 60 patients suffering from staghorn renal calculi were randomized into 2 groups： research group and control group. Each group included 30 patients. All patients received nowenhanced computed tomography scanning and the images of calcili and kidneys were acquired. Besides,the images in research group were reconstructed to get three dimensional images. All patients underwent PCNL operations routinely and some indexes reflecting therapeutic effectiveness were compared subsequently. Results： All procedures were successful and there were no severe complications in all 60 cases. The indexes such as percutaneons track- founding time, intra-operative blood loss, one-stage stone clearance rate, second-stage stone clearance rate in re- search group were all better than in control group. Conclusions：The 3 dimensional CT images of staghorn renal stones can show the details of structure, size and location. It is helpful in designing a more accurate and feasible PCNL access, which can improve stone clearance rate, reduce complications and contrtbute to operation effectiveness.