CT在微创经皮肾镜取石术中的应用  

Clinical application of Computerized tomography in mini-percutaneous nephrolithotripsy

作　　者：傅发军[1] 周刚[1] 杨健[1] 陈新辉[1] 

机构地区：[1]湖南省长沙市中心医院泌尿外科,湖南长沙410004

出　　处：《中国内镜杂志》2011年第5期504-506,共3页China Journal of Endoscopy

摘　　要：目的探讨CT在微创经皮肾镜取石术中的应用价值。方法 2005年03月～2008年12月选择该院899例患者,术前经B超、KUB或KUB+IVU诊断为肾结石和(或)输尿管上段结石,评估术前是否进行CT检查对手术效果的影响。结果 899例患者术前经CT筛查,肾肿瘤并钙化3例,肾实质或血管钙化4例,萎缩无功能肾肾结石27例,UPJO并结石7例、肾囊肿并钙化2例,该组患者不适合行经皮肾镜碎石取石术;856例行皮肾镜取石术,出现术后残石27例;出现穿刺副损伤7例;出现术后大出血4例。结论术前CT检查可以筛查不适合行微创经皮肾镜取石术的病例,并有效提高结石清除率,降低手术并发症,建议作为经皮肾镜碎石取石术前常规检查项目。[Objective] To study the clinical value of computed tomography （CT） for mini-preoperataneous nephrolithotomy （MPCNL）. [Methods] 899 patients with renal calculi or upper ureteral calculi diagnosed by type B ultrasound, KUB, or KUB＋IVU were analyzed retrospectively. The relation between the operative effect and application of CT before operation was evaluated. [Results] Of 899 patients, the mPCNL was not applicable to the following ones：3 renal tumor with calcification, 4 calcification of renal parenchyma or vessel, 27 renal lithiasis of nonfunctional atrophic kidney, 7 lithiasis with calcification and 2 renal cyst with calcification. Of the other 856 ones applied with the mPCNL, 27 suffered from retained calculus after the operation, 7 undertook accompanied injury of puncture and 4 undertook severe hemorrhage after operation. [Conclusions] The application of CT before operation could screen patients who are not applicable to the mPCNL and enforce the clearance of calculus and reduce the complications. CT should be the regular examination before mPCNL.

关 键 词：经皮肾穿刺取石术 计算机X射线断层扫描 肾结石 

分 类 号：R445.6[医药卫生—影像医学与核医学]