摘要
目的：测量斜仰低拱位和俯卧位下肾与结肠的解剖位置变化及相对位移，为经皮肾镜取石术的体位选择提供影像解剖学依据。方法对46例拟行经皮肾镜取石术患者，术前进行斜仰低拱位和俯卧位下64层螺旋CT检查，测量两种体位下的肾水平距离、结肠水平距离、结肠距模拟穿刺线距离和肾结肠距离，并进行比较。结果斜仰低拱位和俯卧位下结肠到模拟穿刺线距离分别为：左侧[（26．56±15．36） mm 和（12．25±13．16） mm，t ＝3．527，P ＜0．05]，右侧[（25．85±14．26） mm和（13．57±12．53） mm，t＝3．234，P＜0．05]，组间比较差异均有统计学意义。斜仰低拱位和俯卧位下左右两侧肾水平距离、结肠水平距离、肾结肠距离比较，差异均无统计学意义（ P＞0．05）。结论斜仰低拱位下结肠向腹侧移位，结肠距模拟穿刺线距离增大，此体位下经皮肾镜取石术有可能降低结肠损伤的发生率，提高手术安全性。
Objective To provide imaging anatomy basis for percutaneous nephrolithotomy （ PCNL） by measuring relative displacement and changes in anatomical position of kidney and colon under the prone and low-oblique supine positions.Methods Forty-six patients scheduled for PCNL underwent 64-slice spiral CT scan under the prone and low-arch oblique supine position before the PCNL.The horizontal distance of kidney and colon,the distance from colon and analog puncturing line,the distance between the kidney and colon were measured and compared between the 2 positions.Results The distance from colon and analog puncturing line under the low-oblique supine and prone positions were as follows,the left （26.56 ±15.36） mm versus （12.25 ±13.16） mm （t=3.527,P〈0.05）,the right （25.85 ±14.26） mm versus （13.57 ± 12.53） mm （t=3.234,P〈0.05）.The differences of the rest distances between the 2 positions were not significant （ P〉0.05）.Conclusions The distance between colon and analog puncturing line increases in the low-arch oblique supine position,because the colon shifts to the ventral.The PCNL in low-arch oblique supine position may reduce the incidence of colon injury,and improve surgical safety.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2015年第6期433-435,共3页
Chinese Journal of Urology
关键词
斜仰低拱位
影像解剖学
肾造口术
经皮
泌尿系结石
Low-arch oblique supine position
Imaging anatomical study
Nephrostomy,percutaneous
Urinary calculi
