非同步俯卧位64层CT在PCNL中的应用  

作　　者：钟煜韡 郑永宏[1] 张载乐 张瑞生[1] 许先华[1] 吴金云[1] 

机构地区：[1]广东惠州市惠阳区人民医院泌尿外科,516211

出　　处：《当代医学》2011年第20期66-67,共2页Contemporary Medicine

摘　　要：目的探讨非同步俯卧位64层CT三维重建结合B超定位在经皮肾镜取石术中的应用价值。方法收集2009年11月～2011年3月肾脏多发结石患者35例,运用B超、IVU和CT检查后,术前模拟术中体位即俯卧位,根据IUV、CT影像设计好穿刺点,用泛影葡胺胶粒在患者体表作标记固定,再行64层CT增强三维重建,在图像上测量出每个穿刺点的角度及深度数据,术中根据数据结合B超实时、引导建立通道。35例患者均行经皮肾镜取石术治疗。结果手术穿刺均一次获得成功。其中单通道取石17例,双通道取石18例,其中一期取石26例,二期取石9例,结石总取净率93.6%。无大出血,血气胸,腹腔脏器损伤等并发症。结论非同步俯卧位64层CT三维重建结合B超定位对复杂性肾结石行PCNL,可显著提高取石通道建立的成功率,增加手术安全性,减少并发症,降低结石残留率。Objective To investigate the effects of CT 3d reconstruction technique combined with B ultrasound in complexity kidney stones.Methods From November 2009 to March 2011,35 patients of complexity kidney stones,under the B ultrasound,IVU and CT examination,preoperative simulation intraoperative postures namely prone position,choose the puncture points,marking in meglumine diatrizoate,enhance by 64 layer CT enhance 3d reconstruction,measuring the Angle and depth of every puncture point,according the data combining B super real-time,build guide channels.All these cases are applied Pereutaneous nePhrolithotomy.Results Puncture all succeed,17 cases are Single channel stone-free,18 cases are Dual channel stone-free,26 cases are one-time stone-free,9 cases in the other are 2 times stone-free successful,the stone-free rate is 93.6%.No complications exit.Conclusion It is valuable about CT 3D reconstruction technique combined with B ultrasound in complexity kidney stones,the advantage of small trauma,definite effect,little bleeding and rapid recovery.Suggest further promotion in clinical.

关 键 词：肾结石 CT 三维成像 经皮肾镜取石术 

分 类 号：R699[医药卫生—泌尿科学]