CT-超声融合在经皮肾穿刺中的应用:一项前瞻性随机对照研究

Application of computed tomography-ultrasound image fusion technique in collecting system puncture:a prospective randomized controlled study

目的:探索CT-超声融合技术指导经皮肾穿刺的有效性及安全性。方法:将2020年4月—2021年2月在我院行经皮肾镜取石术(PCNL)的肾结石患者纳入前瞻性研究,随机分为CT-超声组和超声组。收集并比较患者的一般资料、共定位方式、融合时间、定位时间、穿刺通道、结石清除率等资料。结果:共纳入43例患者,CT-超声组20例,超声组23例。两组患者术前的一般资料均差异无统计学意义。CT-超声组的融合时间为(4.37±0.67)min。CT-超声组和超声组的定位时间分别为(2.69±0.36)min和(3.51±0.57)min,差异有统计学意义(P<0.001);手术时间分别为(71.15±13.87)min和(81.65±15.46)min,差异有统计学意义(P<0.05)。CT-超声组建立的PCN通道较超声组少,差异有统计学意义(P<0.05)。两组患者术后血红蛋白下降、Clavien-Dindo并发症、术后住院天数和结石清除率均差异无统计学意义。结论:与传统的超声引导技术相比,CT-超声融合技术可以缩短超声定位时间,减少所需的PCN通道数量,缩短手术时间。

Objective To demonstrate a novel CT-ultrasound image fusion technique for guiding percutaneous renal puncture in clinical practice.Methods Patients with kidney stones in our hospital from April 2020 to February 2021 were employed in the study,then they were randomly divided into CT-ultrasound group and ultrasound group.The general condition of patients,fusion method,fusion time,ultrasound screening time,simulated puncture channel and so on were compared between the two groups.Results A total of 43 patients were enrolled,including 20 in the CT-ultrasound group and 23 in the ultrasound group.In the CT-ultrasound group,the fusion time was(4.37±0.67)min.The ultrasound screening time of the two groups were(2.69±0.36)min and(3.51±0.57)min,respectively,and the operation time were(71.15±13.87)min and(81.65±15.46)min,respectively.The differences were statistically significant(P<0.01 and P<0.05,respectively).In the CT-ultrasound group,we established fewer PCN channels,and the difference was of statistical significance(P<0.05).Conclusion Compared with traditional ultrasound guidance,CT-ultrasound image fusion technique can shorten the ultrasound screening time,reduce the number of PCN channels,and shorten the operation time.