AIM To explore the value of three-dimensional(3 D) visualization technology in the minimally invasive treatment for infected necrotizing pancreatitis(INP). METHODS Clinical data of 18 patients with INP, who were admit...AIM To explore the value of three-dimensional(3 D) visualization technology in the minimally invasive treatment for infected necrotizing pancreatitis(INP). METHODS Clinical data of 18 patients with INP, who were admitted to the PLA General Hospital in 2017, were retrospectively analyzed. Two-dimensional images of computed tomography were converted into 3 D images based on 3 D visualization technology. The size, number, shape and position of lesions and their relationship with major abdominal vasculature were well displayed. Also, percutaneous catheter drainage(PCD) number and puncture paths were designed through virtual surgery(percutaneous nephroscopic necrosectomy) based on the principle of maximum removal of infected necrosis conveniently.RESULTS Abdominal 3 D visualization images of all the patients were well reconstructed, and the optimal PCD puncture paths were well designed. Infected necrosis was conveniently removed in abundance using a nephroscope during the following surgery, and the median operation time was 102(102 ± 20.7) min. Only 1 patient underwent endoscopic necrosectomy because of residual necrosis. CONCLUSION The 3 D visualization technology could optimize the PCD puncture paths, improving the drainage effect in patients with INP. Moreover, it significantly increased the efficiency of necrosectomy through the rigid nephroscope. As a result, it decreased operation times and improved the prognosis.展开更多
目的:分析辅助可视超微通道经皮肾镜取石术治疗复杂性肾下盏结石的临床疗效。方法:将2019年1月-2020年11月宝鸡市人民医院收治的110例复杂性肾下盏结石患者按照不同的手术方式分为传统组(55例)和超微组(55例),其中传统组给予传统微通道...目的:分析辅助可视超微通道经皮肾镜取石术治疗复杂性肾下盏结石的临床疗效。方法:将2019年1月-2020年11月宝鸡市人民医院收治的110例复杂性肾下盏结石患者按照不同的手术方式分为传统组(55例)和超微组(55例),其中传统组给予传统微通道经皮肾镜取石术治疗,超微组给予辅助可视超微通道经皮肾镜取石术治疗。比较两组患者手术时间、住院时间、住院费用、肾造瘘留置时间、结石清除率及术后血红蛋白下降情况,血清β2-微球蛋白(β2-MG)水平、肾损伤情况[肾损伤因子-1(KIM-1)]以及术后并发症发生情况。结果:与传统组比较,超微组手术时间、住院时间、肾造瘘留置时间、术后血红蛋白下降值均明显降低(P<0.05),结石清除率明显升高(P<0.05);与术前比较,两组治疗后血清β2-MG水平均明显升高(P<0.05),但超微组明显低于传统组(P<0.05);超微组术后24 h、48 h、72 h KIM-1水平均明显低于传统组(P<0.05);两组患者住院费用及术后并发症发生率比较差异无统计学意义(P>0.05)。结论:辅助可视超微通道经皮肾镜治疗复杂性肾下盏结石可有效缩短手术时间、住院时间及肾造瘘留置时间,减轻肾功能损伤,提高结石清除率,安全有效。展开更多
基金Supported by Beijing Natural Science foundation,No.7172201
文摘AIM To explore the value of three-dimensional(3 D) visualization technology in the minimally invasive treatment for infected necrotizing pancreatitis(INP). METHODS Clinical data of 18 patients with INP, who were admitted to the PLA General Hospital in 2017, were retrospectively analyzed. Two-dimensional images of computed tomography were converted into 3 D images based on 3 D visualization technology. The size, number, shape and position of lesions and their relationship with major abdominal vasculature were well displayed. Also, percutaneous catheter drainage(PCD) number and puncture paths were designed through virtual surgery(percutaneous nephroscopic necrosectomy) based on the principle of maximum removal of infected necrosis conveniently.RESULTS Abdominal 3 D visualization images of all the patients were well reconstructed, and the optimal PCD puncture paths were well designed. Infected necrosis was conveniently removed in abundance using a nephroscope during the following surgery, and the median operation time was 102(102 ± 20.7) min. Only 1 patient underwent endoscopic necrosectomy because of residual necrosis. CONCLUSION The 3 D visualization technology could optimize the PCD puncture paths, improving the drainage effect in patients with INP. Moreover, it significantly increased the efficiency of necrosectomy through the rigid nephroscope. As a result, it decreased operation times and improved the prognosis.
文摘目的:分析辅助可视超微通道经皮肾镜取石术治疗复杂性肾下盏结石的临床疗效。方法:将2019年1月-2020年11月宝鸡市人民医院收治的110例复杂性肾下盏结石患者按照不同的手术方式分为传统组(55例)和超微组(55例),其中传统组给予传统微通道经皮肾镜取石术治疗,超微组给予辅助可视超微通道经皮肾镜取石术治疗。比较两组患者手术时间、住院时间、住院费用、肾造瘘留置时间、结石清除率及术后血红蛋白下降情况,血清β2-微球蛋白(β2-MG)水平、肾损伤情况[肾损伤因子-1(KIM-1)]以及术后并发症发生情况。结果:与传统组比较,超微组手术时间、住院时间、肾造瘘留置时间、术后血红蛋白下降值均明显降低(P<0.05),结石清除率明显升高(P<0.05);与术前比较,两组治疗后血清β2-MG水平均明显升高(P<0.05),但超微组明显低于传统组(P<0.05);超微组术后24 h、48 h、72 h KIM-1水平均明显低于传统组(P<0.05);两组患者住院费用及术后并发症发生率比较差异无统计学意义(P>0.05)。结论:辅助可视超微通道经皮肾镜治疗复杂性肾下盏结石可有效缩短手术时间、住院时间及肾造瘘留置时间,减轻肾功能损伤,提高结石清除率,安全有效。