摘要
目的探讨CT平扫轴向旋转视频显像在复杂性肾结石经皮肾镜取石术(PCNL)中结石清除和手术安全性的意义。方法对86例临床及其他检查诊断泌尿系结石的患者术前进行CT平扫及图像多平面重建,经三维重建后合成轴向旋转视频影像,了解结石空间分布关系,并测量PCNL通道与目标肾小盏的角度,设计PCNL通道入路和数目、预测结石可能残余的数目和部位并与手术结果比较。结果 86例患者中,结石肾90侧。经后组中上小盏建立第一通道42侧肾,经后组中下小盏建立第一通道23侧肾,与术前视频显像设计一致;经下盏后上小盏为第二通道入路9侧肾,经下盏后下小盏为第二通道入路5侧肾。一期行PCNL,结石清除率为80%(72/90)。47侧肾残余结石与术前视频显像预测的残余结石相符。术中、术后无大出血及其他严重并发症发生。结论 CT平扫轴向旋转视频显像可直观地提供结石形态和空间分布等信息,有助于设计PCNL通道入路及数目,指导结石寻找,预测残余结石数目与部位,有利于复杂性肾结石PCNL结石清除和手术安全性。
ABSTRACT：Objective To investigate the significance of CT scan axial rotation video imaging for percutaneous nephro‐lithotomy lithotripsy （PCNL） in the management of complex renal calculi .Methods CT scan and MPR imaging were con‐ducted for 86 patients with urinary calculi .CT scan axial rotation video imaging was performed after three‐dimensional recon‐struction .The spacial distribution of calculi was analyzed ,the angles between PCNL channels and targeted calyces renales mi‐nores were measured ,the approach and number of PCNL channels were designed ,and number and location of residual stones were predicted and compared with the results after surgery .Results After PCNL ,the results of 65 sides renal calculi of 86 patients（90 sides renal calculi） were consistent with the preoperative prediction .No intraoperative and postoperative bleeding or other serious complications occurred .Conclusions Renal CT scan axial rotation video imaging can provide stone shape and spatial distribution information visually ,which can help to design the PCNL channels ,predict the number and location of residual stones ,and ensure the clearance rate and surgical safety .
出处
《现代泌尿外科杂志》
CAS
2015年第5期332-335,共4页
Journal of Modern Urology
关键词
CT平扫轴向旋转视频显像
复杂性肾结石
PCNL
结石清除
手术安全性
CT scan axial rotation of video imaging
complex renal calculi
percutaneous nephroscopic lithotomy
stone clearance
surgical safety
