超声波与C臂X线定位在建立经皮肾镜碎石术通道中应用的比较

Comparative study on the application of ultrasonic and C arm X-ray positioning in developing renal tract for percutaneous nephroscopy

目的探讨超声波定位与C臂X线定位在建立经皮肾镜碎石术通道中的价值。方法将106例行经皮肾镜碎石取石术患者按肾积液情况分为轻、中、重度积液组,每组随机再分为两组,分别采用超声波定位和C臂X线定位的方法建立经皮肾镜碎石术通道,记录患者的身高、体重、穿刺次数、穿刺时间、造瘘时间,计算BMI。结果肾轻度积液患者超声波和C臂X线定位的穿刺次数、穿刺时间、造瘘时间分别为(1.18±0.41)次、(8.27±4.67)min、(16.36±1.43)min和(2.09±1.22)次、(17.18±4.40)min、(16.55±1.37)min。肾中度积液患者分别为(1.19±0.48)次、(7.41±3.27)min、(14.56±1.74)min和(1.93±1.24)次、(15.85±4.43)min、(16.63±1.36)min。肾重度积液患者分别为(1.07±0.26)次、(6.87±1.46)min、(13.80±0.94)min和(1.47±0.92)次、(13.93±3.15)min、(13.93±0.79)min。结论超声波与C臂X线定位在建立经皮肾镜碎石术通道中安全有效,超声波定位法可以缩短操作的时间、更容易掌握,更适合在经皮肾镜碎石术通道建立中应用。

Objective To investigate the value of ultrasonic and C arm X-ray positioning in developing renal tract for percutaneous nephrolithotomy （PCNL）. Methods 106 patients treated with PCNL were divided into three groups according to the condition of renal effusion： mild hydronephrosis group, moderate hydronephrosis group and severe hydronephrosis group. Patients in every group was further divided into two subgroups randomly, which were treated with ultrasounic and C arm X-ray positioning respectively. The height, weight, BMI of patients, times of puncture, puncture duration and operation duration were recorded. Results In the mild hydronephrosis group, times of puncture, puncture duration and operation duration were （1.18±0.41） times, （8.27±4.67） rain and （16.36±1.43） rain respectively for patients treated with ultrasounic positioning, and （2.09±1.22） times, （17.18±4.40） rain and （16.55±1.37） rain respectively for patients treated with C arm X-ray positioning. In the moderate hydronephrosis group, the three indexes were （1.19±0.48） times, （7.41 ±3.27） rain and （14.56± 1.74） rain respectively for patients treated with ultrasounic positioning, and （1.93±1.24） times, （15.85±4.43） min and （16.63±1.36） rain respectively for patients treated with C arm X-ray positioning. In the severe hydronephrosis group, the three indexes were （1.07±0.26） times, （6.87± 1.46） rain and （13.80±0.94） min respectively for patients treated with ultrasounic positioning, and （1.47±0.92） times, （13.93±3.15） min and （13.93±0.79） rain respectively for patients treated with C arm X-ray positioning. Conclusion Both ultrasonic and C arm X-ray positioning are safe and effective in developing renal tract for PCNL. However, ultrasonic positioning is preferred for shorter operation duration and easier manipulation.