螺旋CT三维重建及血管造影在经皮肾镜手术中的应用研究

Application of Spiral CT angiography in percutaneous nephrolithotomy surgery

目的:探讨术前行螺旋CT血管造影确定经皮肾镜取石术穿刺部位能否减少术中及术后出血。方法:回顾分析研究组术前行螺旋CT血管造影确定经皮肾镜取石术穿刺部位20例患者,及对照组同期未行螺旋CT血管造影确定经皮肾镜取石术穿刺部位27例患者的临床资料,主要观察术中建立经皮肾穿刺通道的时间及术后较术前血红蛋白下降的情况,评估建立经皮肾穿刺通道的时间及术中出血量的多少有无差异。结果:研究组术中建立经皮肾穿刺通道的时间和术中出血量均较对照组减少,差异有统计学意义(P<0.05)。结论:术前行螺旋CT扫描和三维重建技术确定经皮肾镜术穿刺部位能有效减少建立经皮肾穿刺通道和术中出血,是一种安全、疗效优良的值得临床推广的方法。

Objective To analyze the application of spiral CT angiography before pereutaneous nephrolithotomy surgery whether could reduce intraoperative and postoperative bleeding, with determining the percutaneous nephrolithotomy lithotomy puncture site. Method 20 cases were analyzed retrospectively. All of them were recieved preoperative spiral CT vascular angiography to determine the percutaneous nephrolithotomy lithotomy puncture site. The control group of 27 cases underwent the same surgery without received preoperative spiral CT vascular anglography. The major intraoperative time and postoperative hemoglobin decreasing were assessed. The time of establishing the percutaneous nephrolithotomy channel and blood loss were analyzed. Results Percutaneous renal biopsy channel time and blood loss be- tween the study group and the control group was significant difference （ P 〈 0.05 ）. Conclusion Spiral CT scanning and three - dimensional reconstruction techniques to determine percutaneous nephrolithotomy surgery puncture site can effectively reduce percutaneous renal biopsy channel and blood loss ,so it is safe, excellent, efficacy and worthy of clinical.