B超联合C型臂X光机在经皮肾镜碎石术治疗复杂肾结石中的临床应用价值研究

Clinical Application Value of B-mode Ultrasonograph Combined with Type C Arm X-ray Machine in the Treatment of Percutaneous Nephroscope Lithotripsy Complicated Kidney Stones

目的:探讨B超联合C型臂X光机在经皮肾镜碎石术治疗复杂肾结石中的临床应用价值。方法:选取2014年1月-2015年6月本院收治的进行经皮肾镜碎石术治疗的63例患者为研究对象,根据术中定位方法的不同分为观察组30例和对照组33例,对照组给予B超定位,观察组给予B超联合C型臂X光机定位。比较两种不同定位方式术中、后的临床各项指标。结果:观察组手术时间、术中出血量、住院时间均低于对照组(P<0.05)。观察组术后并发症发生率为10.0%,明显低于对照组的45.45%;观察组一期取石率为96.67%,明显高于对照组的72.72%;观察组残留结石率为3.33%,明显低于对照组的21.21%,差异均有统计学意义(P<0.05)。两组患者术后1个月复查,积水改善、疼痛缓解、血尿缓解情况及结石复发比较差异均无统计学意义(P>0.05)。结论:在B超联合C型臂X光机引导下,有助于PCNL术中建立有效穿刺通道,是一种安全、简便、实用的定位手段值得临床应用并推广。

Objective： To explore clinical application value of B-mode ultrasonography combined with type C arm X-ray machine in the treatment of percutaneous nephroscope lithotripsy on complicated kidney stones. Method： 63 patients admitted in the Hospital for pereutaneous nephroscope lithotripsy treatment from January 2014 to June 2015 were selected as research subjects, who were divided into the observation group （ 30 patients ） and the control group （ 33 patients ） according to different intra-operative localization methods, patients in the control group were subject to B-mode ultrasonography positioning, and patients in the observation group were subject to hepatitis B-mode ultrasonography combined with type-C arm X-ray machine positioning. Intra-operative and post-operative clinical indicators of two different positioning methods were compared. Result： The operation duration, intra- operative blood loss and hospital stay of patients in the observation group were lower than those of patients in the the control group, and the difference satisfied （ P〈0.05 ） . The incidence of postoperative complications of patients in the observation group was 10.0%, lower than that 45.45% of patients in the control group. The removal rate of stones of patients in the observation group was 96.67%, significantly higher than that 72.72% of the control group. The rate of residual stones of patients in the observation group was 3.33%, obviously lower than that 21.21% of the control group. These indicators between the two groups were compared, the differences had statistical significance （ P〈0.05 ） . Postoperative one-month review, hydropsy improvement, pain relief, ease conditions and calculi recurrence of hematuresis of two groups had no differences （ P〉0.05 ） . Conclusion： The guidance of B-mode ultrasonography combined C arm X-ray machine contributes to the establishment of intra-operative effective PCNL puncture channel, being a safe, simple and practical method and worthy of clinical application and promotion.