实时低剂量CT定位与超声定位建立经皮肾通道治疗复杂性肾结石的疗效比较

Comparison of clinical effect in percutaneous nephrolithotomy under real-time CT and B ultrasound guidance

目的对比实时低剂量CT定位与超声定位建立经皮肾通道治疗复杂性肾结石的效果。方法回顾我院2014年1月至2019年1月100例复杂性肾结石患者,分成两组,每组各50例,分别采用实时低剂量CT定位与超声定位穿刺建立经皮肾通道后行经皮肾镜碎石取石术。结果两组患者均采用单通道取石,低剂量CT定位组所有患者均成功建立经皮肾通道,一期结石清除率为90%(45/50),无一例出现大出血、胸腹腔主要脏器损伤等并发症;超声定位穿刺组其中1例建立经皮肾通道过程中因损伤肾静脉中止手术,一期结石清除率为72%(36/50)。结论相对于超声定位穿刺,实时低剂量CT定位穿刺可更安全有效、快速地建立理想的取石通道,一期结石清除率更高,并发症更少,是安全可行、有效的经皮肾穿刺定位方法。

Objective To compare the clinical effect of percutaneous nephrolithotomy under real-time CT and B ultrasound guidance respectively. Method From January 2014 to January 2019, 100 patients with renal stone were treated in our hospital. 50 patients were treated with percutaneous nephrolithotomy under real-time guidance(Group A) while 50 patients under B ultrasound guidance(Group B). Result The percutaneous renal access was successfully established under CT guidance in all patients of group A while renal vein damaged occurred in one case of group B. The stone-free rate was 90% in group A and 72% in group B. Operation time was much shorter in group A. Conclusion Percutaneous nephrolithotomy guided by real-time CT is safe and effective for renal stone.