低剂量和标准剂量螺旋CT定位在微创经皮肾镜碎石取石术应用中的比较  

Camparison of low-dose and standard dose unenhanced helical CT localization in minimally invasive percutaneous nephrolithotomy for upper urinary calculi

作　　者：蒋立城 徐忠华[2] 张英晨 王学廷 丁吉阳 任辉杰 吴志强 王涛 程玉峰 

机构地区：[1]解放军第148中心医院泌尿外科,华东地区尿石病防治山东分基地,山东淄博255300 [2]山东大学齐鲁医院泌尿外科,济南250012 [3]解放军第148中心医院影像科,山东淄博255300

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第5期34-37,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：院长基金资助项目(200930073)

摘　　要：目的通过与标准剂量螺旋CT比较,探讨低剂量螺旋CT定位在上尿路结石微创经皮肾镜碎石取石术(MPCNL)治疗中的应用价值。方法将78例拟行MPCNL治疗的上尿路结石患者,随机分为低剂量螺旋CT扫描定位组(低剂量组)和标准剂量螺旋CT扫描定位组(标准剂量组),于MPCNL前常规行俯卧位扫描定位,确定穿刺点、穿刺角度和深度。分别对两组患者螺旋CT有效辐射量、穿刺次数、皮肾通道建立时间、术中C臂应用次数、失血量及残石率进行比较。结果低剂量组螺旋CT有效辐射量约为标准剂量组的1/4(24.79%),差异有统计学意义(P<0.01),两组在平均穿刺次数、穿刺角度和深度、通道建立时间、失血量、术中C臂应用次数、残石率方面比较无统计学差异(P>0.05)。结论低剂量螺旋CT扫描替代标准剂量螺旋CT扫描行MPCNL定位安全、可行,且有利于降低患者围手术期X线的辐射剂量。fObijectiveTo compare the clinical value of low-dose and standard dose unenhanced helical CT localization in minimally invasive percutaneous nephrolithotomy （MPCNL） for upper urinary tract caculi. Mothods 78 cases of patients suffered from upper urinary tract stones were recruited to the study, all patients were divided into two groups, low-dose helical CT localizing group （low-dose group） and standard-dose helical CT localizing group （standard-dose group）, and undertook a conventional helical CT localization before MPCNL in prone position to determine the puncture point, puncture angle and puncture depth. The effective radiation of CT scan in patients, puncture times, buildup time ofpercutaneous nephrolithotomy channel, times of intraoperative C-arm use, blood loss and residual stone rate were compared between the two groups. Rosults Signifant differences of effective radiation of helical CT were found between the two groups （P〈0.001）, with a ratio of 1/4 （24.79%） in low-dose group to standard-dose group. No differences were found in the average number of puncture times, puncture angle and depth, channel buildup time, times of C-arm use, blood loss and residual stone between the two groups （all P〉0.05）. Conclusion Low-dose helical CT scan could be an alternative choice in localization for MPCNL with safetyand feaserbility, be profit to helping reducing the perioperative radiation dose of X-ray and use of intraoperative C-arm applications in patients.

关 键 词：CT 肾造口术 经皮 辐射 

分 类 号：R699.2[医药卫生—泌尿科学]