术前CT平扫在经皮肾镜取石术治疗鹿角形肾结石中的意义

The significance of non-enhanced CT staghorn calculi before percutaneous nephrolithotomy

目的：评估术前CT平扫在经皮。肾镜取石术（PCNL）治疗鹿角形肾结石中的意义。方法：将2013年1月～2013年12月收治的68例阳性鹿角形肾结石患者按是否术前行CT平扫分为传统检查组（传统组）34例及CT平扫组（CT组）34例，并将鹿角形结石分层，两组间结石最大直径匹配，以评估预期目标。肾盏（首选肾盏）与实际穿刺中肾盏符合率、一期手术结石清除率指标，并进行对照研究。结果：传统组肾盏符合率为67．6％（23／34），一期手术结石清除率为38．2％（13／34），1例患者发生邻近组织脏器损伤；CT组肾盏符合率为88．2％（30／34），一期手术结石清除率为64．7％（22／34），没有邻近组织脏器损伤的发生。两组间的。肾盏符合率和结石清除率比较，差异均有统计学意义（P〈O．05）。结论：术前CT平扫可提高目标肾盏与实际肾盏的符合率，提高PCNI。治疗鹿角形。肾结石的结石清除率，并可能减少邻近组织脏器损伤的发生。

Objective.. To discuss the clinical application and significance of non-enhanced computed tomography in PCNL for staghorn calculi. Method： 68 staghorn calculi patients were divided into two groups prospectively from january 2013 to December 2013, the group was divided by whether non-enhanced computed tomography be done or not preoperatively, routine group and CT group, staghorn calculi stratified into complete stag- horn calculi and partial staghorn calculi, each group had 34 cases , PCNL accesses were designed, to Calculate the rate of the expected target calyx in comply with the actual calyx, and the stone - free rate. Result： The Coincidence rate designed calyx to actual calyx was 67.6% （23/34） in the routine group, The stone-flee rate was 38.2% （13/ 34） in the routine group, one pleural injury occurred in one patient with complete staghorn calculi,, the Coinci- dence rate designed calyx to actual calyx was 88.2% （30/34） in the CT group,. The stone-free rate was 64.7% （22/34） in the CT group, No adjacent organ damage occurs. The Coincidence rate and stone-free rate between the two groups were statistically significant. Conclusion： Non-enhanced CT provided the detail information not only help to improve the coincidence rate designed calyx to actual calyx, , but also improve the stone-free rates of Stag- horn calculi by percutaneous nephrolithotomy monotherapy, and may reduce the incidence of adjacent organ dam- age and ensuring operation safety.