现代泌尿外科杂志
現代泌尿外科雜誌
현대비뇨외과잡지
JOURNAL OF MODERN UROLOGY
2015年
5期
332-335
,共4页
钟煜韡%刘继普%郑永宏%吴金云%张世科
鐘煜韡%劉繼普%鄭永宏%吳金雲%張世科
종욱위%류계보%정영굉%오금운%장세과
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平掃軸嚮鏇轉視頻顯像%複雜性腎結石%PCNL%結石清除%手術安全性
CT평소축향선전시빈현상%복잡성신결석%PCNL%결석청제%수술안전성
CT scan axial rotation of video imaging%complex renal calculi%percutaneous nephroscopic lithotomy%stone clearance%surgical safety
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C T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。
目的：探討CT平掃軸嚮鏇轉視頻顯像在複雜性腎結石經皮腎鏡取石術（PCNL）中結石清除和手術安全性的意義。方法對86例臨床及其他檢查診斷泌尿繫結石的患者術前進行C T平掃及圖像多平麵重建，經三維重建後閤成軸嚮鏇轉視頻影像，瞭解結石空間分佈關繫，併測量PCNL通道與目標腎小盞的角度，設計 PCNL通道入路和數目、預測結石可能殘餘的數目和部位併與手術結果比較。結果86例患者中，結石腎90側。經後組中上小盞建立第一通道42側腎，經後組中下小盞建立第一通道23側腎，與術前視頻顯像設計一緻；經下盞後上小盞為第二通道入路9側腎，經下盞後下小盞為第二通道入路5側腎。一期行PCNL ，結石清除率為80％（72／90）。47側腎殘餘結石與術前視頻顯像預測的殘餘結石相符。術中、術後無大齣血及其他嚴重併髮癥髮生。結論 CT平掃軸嚮鏇轉視頻顯像可直觀地提供結石形態和空間分佈等信息，有助于設計 PCNL通道入路及數目，指導結石尋找，預測殘餘結石數目與部位，有利于複雜性腎結石PCNL結石清除和手術安全性。
목적：탐토CT평소축향선전시빈현상재복잡성신결석경피신경취석술（PCNL）중결석청제화수술안전성적의의。방법대86례림상급기타검사진단비뇨계결석적환자술전진행C T평소급도상다평면중건，경삼유중건후합성축향선전시빈영상，료해결석공간분포관계，병측량PCNL통도여목표신소잔적각도，설계 PCNL통도입로화수목、예측결석가능잔여적수목화부위병여수술결과비교。결과86례환자중，결석신90측。경후조중상소잔건립제일통도42측신，경후조중하소잔건립제일통도23측신，여술전시빈현상설계일치；경하잔후상소잔위제이통도입로9측신，경하잔후하소잔위제이통도입로5측신。일기행PCNL ，결석청제솔위80％（72／90）。47측신잔여결석여술전시빈현상예측적잔여결석상부。술중、술후무대출혈급기타엄중병발증발생。결론 CT평소축향선전시빈현상가직관지제공결석형태화공간분포등신식，유조우설계 PCNL통도입로급수목，지도결석심조，예측잔여결석수목여부위，유리우복잡성신결석PCNL결석청제화수술안전성。
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 .
