实时低剂量CT定位穿刺在复杂肾结石经皮肾镜术中的应用  

Treatment of complex renal stone with percutaneous nephrolithotomy under real-time low-dose CT guidance

作　　者：覃智标[1] 雷华[1] 张家宙[2] 毕革文[1] 黄瑞旭[1] 赵书晓[1] 郑仿[1] 黄崛倬 

机构地区：[1]广西中医药大学第一附属医院泌尿外科,南宁530021 [2]广西中医药大学第一附属医院射科科,南宁530021

出　　处：《中华腔镜泌尿外科杂志（电子版）》2016年第1期33-35,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨实时低剂量CT定位穿刺法建立经皮肾通道在复杂肾结石经皮肾镜术中的临床应用价值。方法广西中医药大学第一附属医院于2014年6月至2014年12月对30例复杂肾结石患者术前采用低剂量CT引导定位穿刺建立经皮肾通道后行经皮肾镜术,回顾性分析其临床资料。结果所有患者均成功建立经皮肾通道,其中单通道取石24例,双通道取石6例,Ⅰ期手术27例,Ⅱ期手术3例,清石率为90%,无一例出现大出血、胸腹腔脏器损伤、尿源性脓毒血症等并发症,无一例需术中或术后输血。结论实时低剂量CT定位穿刺法,可安全有效的建立理想的取石通道,提高复杂肾结石经皮肾镜碎石术的成功率,减少并发症,同时降低了患者接受的辐射剂量。Objective To evaluate the clinical effect of percutaneous nephrolithotomy under real-time low-dose CT guidance for the treatment of complex renal stone. Method Thirty patients with complex renal stone were treated with percutaneous nephrolithotomy under real-time low-dose CT guidance from June 2014 to December 2014 in First Affiliated Hospital of Guangxi Chinese Traditional Medical University. The date were analyzed retrospectively. Result The percutaneous renal access was successfully established under CT guidance in all patients, with single access percutaneous nephrolithotomy in 24 cases, double access in 6 cases, immediate phase Ⅰ lithotripsy was performed in 27 cases and delayed phase Ⅱ lithotripsy in 3 cases. The stone-free rate was 90%. No one needed transfusion, no serious complications occurred. Conclusion Percutaneous nephrolithotomy guided by real-time CT is safe and effective to treat complex renal stone.

关 键 词：肾结石 肾造口术 经皮 CT 

分 类 号：R699.2[医药卫生—泌尿科学]