术前采用非同步俯卧位64层CT三维图像重建结合彩超定位在PCNL的应用研究

Preoperative use of non- prone position synchronized 64- slice CT three- dimensional image reconstruction combined with ultrasound in the positioning application of PCNL

目的探讨术前采用非同步俯卧位64层CT三维图像重建结合彩超定位在经皮肾镜取石(PCNL)中的应用效果。方法选取2012年1月至2013年12月接受PCNL治疗的复杂性结石患者60例,随机分为观察组(n=30)和对照组(n=30)。观察组患者采取术前非同步俯卧位64层CT扫描结合术中彩超定位,对照组患者采用单纯术中B超引导定位。观察并比较两组患者的一次穿刺成功率、手术时间、结石清楚率、并发症发生率。结果观察组患者的一次穿刺成功率、结石清除率显著高于对照组(P<0.05),手术时间、并发症发生率显著低于对照组(P<0.05)。结论通过应用术前非同步俯卧位64层CT三维重建结合术中彩超定位在PCNL中建立通道,能够有效地提高取石通道建立的成功率,提高取硬石效率,降低残留率,减少手术并发症,显著提了PCNL的疗效。

Objective To explore the application effect of preoperative asynchronous prone position 64 layer CT three - dimensional image reconstruction combined with ultrasound in the positioning application of PCNL. Methods 60 complexity calculi patients from January 2012 to December 2013 in our hospital were selected and randomly divided into the observation group（n = 30）and the control group（n = 30）. The pa-tients in the observation group performed preoperative asynchronous prone position 64 layer CT scanning combined with intraoperative color B ultra-sound positioning,the patients in the control group performed simple intraoperative ultrasound guide positioning. The success rate of the first punc-ture,operation time,stone clear rate,incidence of complications of the two groups were observed and compared. Results The rate of first punc-ture success,the rate of stone clear in the observation group was significantly higher than the control group（ P 〈 0. 05）;the operation time,the complication incidence in the observation group was significantly shorter than the control group（ P 〈 0. 05）. Conclusion By applying the preop-erative non - prone position synchronized 64 - slice CT three - dimensional image reconstruction combined with intraoperative color ultrasound in PCNL,the success rate of the lithotomy channel effectively improved,the residual rate and the surgical complications rate can be reduced and the curative effect of PCNL was raised significantly.