CT精准定位下经皮肾穿刺取石术的临床研究
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摘要
目的探讨CT精准定位下经皮肾穿刺取石术(PCNL)治疗上尿路结石的安全性及疗效。方法选取行PCNL的上尿路结石患者60例,随机分为CT组、 B超组、 X-Ray组,每组20例,比较三组的手术指标和效果。结果 CT组的碎石效率、结石清除率、出血量、术后住院时间、住院费用均显著优于B超、 X-Ray组,差异有统计学意义(P <0.05);三组的穿刺通道数、感染指标比较,差异均无统计学意义(P>0.05)。结论 CT引导的定位穿刺可以满足PCNL的需求,能为患者提供更加精准的、安全的穿刺扩张定位。
Objective To explore the safety and efficacy of percutaneous nephrolithotomy(PCNL) under CT accurate location for the treatment of upper urinary calculi. Methods Sixty patients with upper urinary calculi who received PCNL were randomly divided into the CT group, B-ultrasound group and X-Ray group, with 20 cases in each group. The surgical indicators and effects were compared among the three groups. Results The lithotripsy efficiency, stone clearance rate, bleeding volume, postoperative hospitalization time and hospitalization cost of the CT group were significantly better than those of the B ultrasound group and X-Ray group(P <0.05). No statistical difference was found among the three groups in the number of puncture channels and infection indicator(P >0.05). Conclusions CT-guided positioning puncture can meet the needs of PCNL and provide patients with more accurate and safe puncture and expansion positioning.
Objective To explore the safety and efficacy of percutaneous nephrolithotomy(PCNL) under CT accurate location for the treatment of upper urinary calculi. Methods Sixty patients with upper urinary calculi who received PCNL were randomly divided into the CT group, B-ultrasound group and X-Ray group, with 20 cases in each group. The surgical indicators and effects were compared among the three groups. Results The lithotripsy efficiency, stone clearance rate, bleeding volume, postoperative hospitalization time and hospitalization cost of the CT group were significantly better than those of the B ultrasound group and X-Ray group(P <0.05). No statistical difference was found among the three groups in the number of puncture channels and infection indicator(P >0.05). Conclusions CT-guided positioning puncture can meet the needs of PCNL and provide patients with more accurate and safe puncture and expansion positioning.
引文
[1]那彦群,叶章群,孙颖浩,等. 2014版中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社, 2014:169-172.
[2]陈亮,李建兴.经皮肾镜碎石取石术的并发症的防治[J].现代泌尿外科杂志, 2013, 18(6):527-531.
[3] El-Nahas AR, Eraky I, Shokeir AA, et al. Factors affecting stone-freerate and complications of percutaneous nephrolithotomy for treatmentof staghorn stone[J]. Urology, 2012, 79(6):1236-1241.
[4]梁卓寅,王露萍,陈秀萌,等. CT三维重建尿路显像术在微创经皮肾穿刺取石术中的应用[J].国际泌尿系统杂志, 2008, 28(2):149-151.
[5] Ghani KR, Patel U, Anson K. Planning percutaneous nephrolithotomyusing multidetector computed tomography urography, multiplanar re-construction and three-dimensional reformatting[J]. BJU Int, 2005,96(6):916-917.
[6] Matlaga BR, Shah OD, Zagoria RJ, et al. Computerized tomographyguided access for percutaneous nephrostolithotomy[J]. J Urol, 2003,170(1):45-47.
[2]陈亮,李建兴.经皮肾镜碎石取石术的并发症的防治[J].现代泌尿外科杂志, 2013, 18(6):527-531.
[3] El-Nahas AR, Eraky I, Shokeir AA, et al. Factors affecting stone-freerate and complications of percutaneous nephrolithotomy for treatmentof staghorn stone[J]. Urology, 2012, 79(6):1236-1241.
[4]梁卓寅,王露萍,陈秀萌,等. CT三维重建尿路显像术在微创经皮肾穿刺取石术中的应用[J].国际泌尿系统杂志, 2008, 28(2):149-151.
[5] Ghani KR, Patel U, Anson K. Planning percutaneous nephrolithotomyusing multidetector computed tomography urography, multiplanar re-construction and three-dimensional reformatting[J]. BJU Int, 2005,96(6):916-917.
[6] Matlaga BR, Shah OD, Zagoria RJ, et al. Computerized tomographyguided access for percutaneous nephrostolithotomy[J]. J Urol, 2003,170(1):45-47.