仰卧位与模拟术中俯卧位CT对经皮肾穿刺定位精准性的对比研究  

Supine position and simulation of intraoperative prone position CT on accuracy of percutaneous renal puncture positioning: a comparative study

作　　者：黄韬[1] 龙兆麟[1] 吴丽祯 吴世皓[1] 华庆生[1] 刘志乐[1] 张信基[1] 

机构地区：[1]南方医科大学附属顺德第一人民医院泌尿外科,广东佛山528300

出　　处：《广州医科大学学报》2016年第5期61-64,共4页Academic Journal of Guangzhou Medical University

基　　金：佛山市医学科学技术应用研究(2014AB001623)

摘　　要：目的:对比行经皮肾穿刺取石术患者在仰卧位及模拟术中俯卧位时,肾脏、结肠的位置和角度的变化,探讨术前行模拟术中俯卧位CT检查的临床价值。方法:回顾性分析2014年3月至2016年2月在南方医科大学附属顺德第一人民医院确诊的200例肾结石和输尿管上段结石患者的临床资料,比较仰卧位与模拟术中俯卧位CT时肾水平/垂直距离、结肠水平/垂直距离、肾-结肠相对水平/垂直距离、肾-结肠最短距离、冠状位肾长轴角度的差异。结果:从仰卧位改为模拟术中俯卧位行CT检查时,双侧肾脏和结肠均移向腹侧,冠状位肾长轴角度,差异有统计学意义(P<0.05)。结论:同术前仰卧位CT预定位相比,术前模拟术中俯卧位CT有助于制定穿刺路径,从而提高穿刺成功率,减少结肠损伤风险。Objective： To investigate the clinical value of the simulation of intraoperative prone position CT before the operation through comparing the changes of the position and angle of the kidney and colon in patients,who were scheduled for percutaneous nephrolithotomy with supine position and simulation of intraoperative prone position. Methods： The clinical data of 200 patients with nephrolithiasis and upper ureteral calculi,who were diagnosed at Shunde First Municipal People＇s Hospital Affiliated to Southern Medical University between March2014 and February 2016, were retrospectively analyzed. The differences in the kidney horizontal/vertical distance,colon,horizontal/vertical distance,kidney-colon relative horizontal/vertical distance,the shortest renal-colon distance and coronal renal long axis angle were compared between the supine position and simulation of intraoperative prone position CT. Results： Changing from the supine position to the simulation of intraoperative prone position CT,the bilateral kidney and colon were moved to the ventral side,and the difference in the coronal renal long axis angle was statistically significant（ P〈0.05）. Conclusion： Compared with supine position guided by CT pre-positioning,the simulation of intraoperative prone position CT favors the establishment of puncture pathways during the simulation of intraoperative prone position CT before the operation,so as to improve the success rate of puncture and reduce the risk of colon injury.

关 键 词：CT检查 经皮肾穿刺取石术 仰卧位 俯卧位 结肠损伤 

分 类 号：R692.4[医药卫生—泌尿科学]