[1]韦钢山,黄向华,覃斌等.CT尿路成像及三维重建在微创经皮肾镜取石术中的价值[J].中国微创外科杂志,2012,12(6):530-533.
　Wei Gangshan,Huang Xianghua,Qin Bin,et al.CT Urography and 3D Reconstruction in Percutaneous Nephrolithotomy[J].Chinese Journal of Minimally Invasive Surgery,2012,12(6):530-533.
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CT尿路成像及三维重建在微创经皮肾镜取石术中的价值()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
12
期数:
2012年6期
页码:
530-533
栏目:
出版日期:
2012-06-15

文章信息/Info

Title:
CT Urography and 3D Reconstruction in Percutaneous Nephrolithotomy
作者:
韦钢山; 黄向华; 覃斌等
广西壮族自治区贵港市人民医院泌尿外科，贵港537100
Author(s):
Wei Gangshan;  Huang Xianghua;  Qin Bin;  et al.
Department of Urology, Guigang People’ s Hospital, Guigang 537100, China
关键词:
CT尿路成像; 三维重建; 微创经皮肾镜取石术; 上尿路结石
Keywords:
CT urography; Threedimensional reconstruction; Percutaneous nephrolithotomy; Upper urinary calculi
分类号:
R692.4
文献标志码:
A
摘要:
目的探讨上尿路结石中CT尿路成像（CT urography,CTU）及三维重建在微创经皮肾镜取石术中的应用价值。方法选取2008年1月~2010年12月微创经皮肾镜取石术68例作为研究对象,CTU及三维重建38例(CTU组),静脉肾盂造影（intravenous pyelography,IVP）30例(IVP组)。比较2组手术时间、术中出血量、穿刺通道数目、结石清除率及并发症发生率。结果2组手术均获成功，无严重并发症发生。CTU组手术时间（95.0±37.4）min,显著短于IVP组（125.8±36.5）min(t=-3.408,P=0.001)；CTU组术中出血量(114.3±44.2)ml与IVP组（133.7±35.7）ml无统计学差异(t=-1.952,P=0055)；CTU组单、双通道分别为32、6例，与IVP组25、5例无统计学差异（χ2=0.010,P=0.922)；CTU组结石清除率921%（35/38）与IVP组73.3%（22/30）无统计学差异（χ2=3.082,P=0.079)；CTU组穿刺成功率89.5%(34/38)明显高于IVP组70.0%(21/30)( χ2=4.112,P=0.043)。结论CTU联合三维重建技术能提高结石检出率，不增加X线的放射剂量，提供精确的穿刺径路，减少穿刺损伤周围脏器的风险，缩短手术时间，提高穿刺成功率，从而减少或避免术后并发症。
Abstract:
ObjectiveTo investigate the value of CT urography (CTU) and 3D reconstruction in minimally invasive percutaneous nephrolithotomy.MethodsFrom January 2008 to December 2010, 68 patients with renal or ureteral calculi underwent minimally invasive percutaneous nephrolithotomy (MPCNL) in our hospital. Among the patients, 38 cases received CTU and 3D reconstruction (CTU group), and the other 30 received intravenous pyelography (IVP group). The operation time, intraoperative blood loss, number of punctural channels, rate of stone clearance, and rate of complications were compared between the two groups.ResultsThe procedures were completed successfully in both the groups without severe complications occurred. Compared to the IVP group, the CTU group showed significantly shorter operation time and higher success rate of puncture ［(95.0±37.4) min vs. (1258±36.5) min, t=-3.408, P=0.001; 89.5% (34/38) vs. 70.0% (21/30), χ2=4.112, P=0.043］. No significant difference was detected in the intraoperative blood loss, number of single and double channels, and rate of stone clearance between the two groups ［(114.3±44.2)ml vs. (133.7±35.7) m, t=-1.952, P=0.055; 32 and 6 cases vs. 25 and 5 cases, χ2=0.010, P=0.922; 92.1% (35/38) vs.73.3% (22/30), χ2=3.082,P=0.079］.ConclusionsCTU plus 3D reconstruction can increase the detection rate of calculus without raising the dosage of Xray. It provides a precise puncture approach, which decreases the rate of injury to the adjacent organs, reduces operation time, increases success rate of puncture, and avoids postoperative complications.

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更新日期/Last Update: 2012-06-15