CT尿路造影预定位联合超声实时引导在微创经皮肾镜碎石术穿刺中的应用效果  

Application effect of CT urography pre-positioning combined with real-time ultrasound guidance in minimally invasive percutaneous nephrolithotripsy puncture

作　　者：卢章铭 苏伟绩 Lu Zhangming;Su Weiji(Department of Surgery,Liaobu Hospital,Dongguan,Guangdong 523409,China)

机构地区：[1]东莞市寮步医院外科,广东东莞523409

出　　处：《泌尿外科杂志（电子版）》2024年第3期25-28,共4页Journal of Urology for Clinicians(Electronic Version)

基　　金：东莞市社会发展科技项目(20211800900012)。

摘　　要：目的探讨CT尿路造影(CT urography,CTU)预定位联合超声实时引导在微创经皮肾镜碎石术(percutaneous nephrolithotomy,PCNL)穿刺中的应用效果。方法选取2022年3月至2023年12月东莞市寮步医院收治的50例肾、输尿管上段结石患者作为研究对象,按照随机数字表法分为对照组与观察组,每组25例。对照组采用超声实时引导下的PCNL治疗,观察组采用术前CTU预定位联合超声实时引导下的PCNL治疗。比较两组围手术期指标、一次性建立通道成功率、结石清除率、并发症发生率。结果观察组通道建立、手术时间短于对照组,术中失血量、血红蛋白损失量低于对照组,差异有统计学意义(P<0.05)。观察组一次性建立通道成功率、I期结石清除率高于对照组,差异有统计学意义(P<0.05);两组Ⅱ期结石清除率比较,差异无统计学意义(P>0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论采用CTU预定位联合超声实时引导下的PCNL,可缩短通道建立及手术时间,降低失血量,稳定血红蛋白水平,提高一次性建立通道成功率及结石清除率,安全性较高。Objective To explore the application effect of CT urography(CTU)pre-positioning combined with real-time ultrasound guidance in minimally invasive percutaneous nephrolithotomy(PCNL)puncture.Methods Fifty patients with kidney and upper ureteral stones admitted to Liaobu Hospital in Dongguan City from March 2022 to December 2023 were selected as the study subjects.They were randomly divided into a control group and an observation group,with 25 cases in each group,using a random number table method.The control group received PCNL treatment under real-time ultrasound guidance,while the observation group received preoperative CTU pre-positioning combined with PCNL treatment under real-time ultrasound guidance.The perioperative indicators of two groups,including the success rate of establishing a single channel,stone clearance rate,and incidence of complications were compared.Results The observation group had shorter channel establishment and surgery time compared to the control group,with lower intraoperative blood loss and hemoglobin loss compared to the control group,and the difference was statistically significant(P<0.05).The success rate of establishing a single channel and the clearance rate of stageⅠstones in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the clearance rate of stageⅡstones between the two groups(P>0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion The use of CTU pre-positioning combined with real-time ultrasound guided PCNL can shorten the time for channel establishment and surgery,reduce blood loss,stabilize hemoglobin levels,improve the success rate of one-time channel establishment and stone clearance,and has high safety.

关 键 词：肾结石 输尿管结石 尿路造影 经皮肾镜碎石术 

分 类 号：R445.3[医药卫生—影像医学与核医学]