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经皮微通道-微电子肾镜-微超声探针碎石术治疗1.5~2.5 cm肾结石的疗效和安全性
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作者 王明瑞 刘军 +4 位作者 熊六林 于路平 胡浩 许克新 徐涛 《北京大学学报(医学版)》 CAS CSCD 北大核心 2024年第4期605-609,共5页
目的:探讨经皮微通道-微电子肾镜-微超声探针碎石术(mini-track,mini-nephroscopy and mini-ultrasonic probe percutaneous nephrolithotomy,3mPCNL)治疗1.5~2.5 cm肾结石的有效性和安全性。方法:回顾性分析2023年11月至2024年1月共25... 目的:探讨经皮微通道-微电子肾镜-微超声探针碎石术(mini-track,mini-nephroscopy and mini-ultrasonic probe percutaneous nephrolithotomy,3mPCNL)治疗1.5~2.5 cm肾结石的有效性和安全性。方法:回顾性分析2023年11月至2024年1月共25例在北京大学人民医院行超声引导下3mPCNL的1.5~2.5 cm肾结石患者的围手术期资料和术后随访资料,匹配同时期内25例接受标准通道经皮肾镜碎石术(standard percutaneous nephrolithotomy,sPCNL)的1.5~2.5 cm肾结石患者,按照两组患者结石最大径差值的绝对值≤1 mm的标准进行一对一匹配,对比两种治疗方式的手术时间、肾功能改变情况、术后无石率、血红蛋白改变情况以及并发症率,进而初步分析3mPCNL治疗1.5~2.5 cm肾结石的有效性和安全性。结果:3mPCNL组和sPCNL组患者在平均年龄、术前中位血肌酐、术前平均血红蛋白、术前平均红细胞压积、中位结石最大径和中位结石CT密度值之间的差异均无统计学意义,两组全部为单发结石。3mPCNL组患者的中位手术时间为60.0(45.0~110.0)min,与sPCNL组相比差异无统计学意义,全部为单通道手术。3mPCNL组术后平均血红蛋白为(115.3±15.5)mmol/L,与术前相比差异无统计学意义,平均血红蛋白降低值与sPCNL组相比差异无统计学意义[(9.5±2.2)mmol/L vs.(10.1±1.9)mmol/L]。3mPCNL组术后平均红细胞压积为(28.0±5.2)%,与术前相比差异有统计学意义(t=2.414,P=0.020),平均红细胞压积降低值与sPCNL组相比差异无统计学意义(2.3%vs.2.7%)。3mPCNL组术后中位血肌酐为74.0(51.0~118.0)μmol/L,与术前相比差异有统计学意义(Z=-2.980,P=0.005)。3mPCNL组和sPCNL组术后无石率分别为96.0%和97.3%,术后平均住院时间分别为(4.3±1.4)d和(5.5±2.0)d,差异有统计学意义(t=0.192,P=0.025)。1例sPCNL组患者拔除肾造瘘管后出现大量出血,行选择性肾动脉栓塞治疗后好转;1例3mPCNL组患者出现轻度肾周血肿,行保守治疗后好转,其余患者均未见并发症。结论:3mPCNL治疗1.5~2.5 cm肾结石可以达到与sPCNL相当的有效率,可以在较短的手术时间内获得理想的术后无石率,且手术相关并发症率较低。 展开更多
关键词 肾结石 电子肾镜 微超声探针 泌尿外科手术
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Preoperative TN staging of esophageal cancer: Comparison of miniprobe ultrasonography, spiral CT and MRI 被引量:59
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作者 Ling-FeiWu Bing-ZhouWang +4 位作者 Jia-LinFeng Wei-RongCheng Guo-RuiLiu Xiao-HuaXu Zhi-ChaoZheng 《World Journal of Gastroenterology》 SCIE CAS CSCD 2003年第2期219-224,共6页
AIM: To evaluate the value of miniprobe sonography (MPS),spiral CT and MR imaging (MRI) in the tumor and regionallymph nocle staging of esophageal cancer.METHODS: Eight-six patients (56 men and 30 women; agerange of 3... AIM: To evaluate the value of miniprobe sonography (MPS),spiral CT and MR imaging (MRI) in the tumor and regionallymph nocle staging of esophageal cancer.METHODS: Eight-six patients (56 men and 30 women; agerange of 39-73 years, mean 62 years) with esophagealcarcinoma were staged .preoperatively with imagingmodalities. Of them, 81 (94 %) had squamous cell carcinoma,4(5 %) adenocarcinoma, and 1(1%) adenoacanthoma.Eleven patients (12 %) had malignancy of the upper onethird, 41 (48 %) of the mid-esophagus and 34 (40 %) ofthe distal one third. Forty-one were examined by spiral CTin whom 13 were co-examined by MPS, and forty-five byMRI in whom 18 were also co-examined by MPS. Theseimaging results were compared with the findings of thehistopathologic examination for resected specimens.RESULTS: In staging the depth of tumor growth, MPS wassignificantly more accurate (84 %) than spiral CT and MRI(68 % and 60 %, respectively, P<0.05). The specificity andsensitivity were 82 % and 85 % for MPS; 60 % and 69 % forspiral CT; and 40 % and 63 % for MRI, respectively. In stagingregional lymph nodes, spiral CT was more accurate (78 %)than MPS and MRI (71% and 64 %, respectively), but thedifference was not statistically significant. The specificity andsensitivity were 79 % and 77 % for spiral CT; 75 % and 68 %for MPS; and 68 % and 62 % for MRI, respectively.CONCLUSION:MPS is superior to spiral CT or MRI for Tstaging, especially in early esophageal cancer. However,the three modalities have the similar accuracy in N staging.Spiral CT or MRI is helpful for the detection of far-distancemetastasis in esophageal cancer. 展开更多
关键词 探针超声检查 食管癌 CT检查 核磁共振 影像学诊断 临床分期
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