彩超引导定位联合CT三维重建在经皮肾取石术中应用研究

Curative effect observation of CT three dimensional reconstruction combined with color Doppler ultrasound of the percutaneous renal biopsy in inclined back rock bit

目的 CT三维重建联合彩超在斜仰截石位经皮肾镜取石术（percutaneous nephrolithotomy,PCNL）中穿刺定位的疗效观察.方法 选取2012年5月至2015年6月在本院行斜仰截石位PCNL的复杂性肾结石患者104例,根据CT三维重建是否联合彩超定位穿刺分组,比较两组患者的手术情况,术后肾血流情况,术后结石清除率和手术并发症的差异.结果 观察组（54例）的手术时间、穿刺时间、血红蛋白损失量均低于对照组（50例）,且差异具有统计学意义（P＜0.05）;观察组一次性建立通道率（49例,90.74％）高于对照组（38例,76.0％）,且差异具有统计学意义（P＜0.05）.观察组的肾血流速度和阻力指数与对照组的差异无统计学意义（P＞0.05）.观察组的结石清除率（46例,85.18％）高于对照组（29例,58.0％）,且差异具有统计学意义（P＜0.05）;观察组的术后并发症发生率（3例,5.56％）低于对照组（10例,20.0％）,且差异具有统计学意义（P＜0.05）.结论 CT三维重建联合彩超定位穿刺在斜仰截石位经皮肾取石术治疗复杂性肾结石的疗效优于单纯CT三维重建定位穿刺.

Objectives To investigate the curative effect of CT three-dimensional reconstruction combined with color Doppler ultrasound of the percutaneous nephrolithotomy （PCNL） in inclined back rock bit.Methods A total of 104 patients with complex renal calculi who underwent PCNL in our hospital from May 2013 to June 2015 were selected and divided into two groups,according to whether the CT three-dimensional reconstruction combined with color Doppler ultrasound localization puncture.Differences of the surgery condition,postoperative renal blood flow,postoperative stone clearance rate and surgical complications were compared between the two groups.Results The operation time,puncture time,hemoglobin loss in the observation group were lower than the control group,and the difference was statistically significant （P 〈 0.05）.The rate of disposable channel establishment in the observation group（49 cases,90.74%） was higher than that of the control group （38 cases,76%）,and the difference was statistically significant（P 〈 0.05）.There was no significant difference in the renal blood flow velocity and resistance index between the observation group and the control group（P〉0.05）.The stone clearance rate in the observation group （46 cases,85.18%） was higher than that in the control group （29 cases,58%）,and the difference was statistically significant （P 〈0.05）.The incidence of postoperative complications in the observation group （3,5.56%） was lower than that in the control group （10 cases,20%）,and the difference was statistically significant （P 〈 0.05）.Conclusions CT three-dimensional reconstruction combined with color Doppler ultrasound localization puncture of PCNL in inclined back rock bit for treatment of complex renal calculi is better than the simple CT three-dimensional reconstruction localization puncture.