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目的:探讨64层CT三维图像重建结合B超定位在经皮肾镜取石术中的应用价值。方法:对154例肾结石患者术前采用肾脏64层螺旋CT扫描,其中58例行三维图像重建;154例均在B超定位下行经皮肾镜碎石取石术。结果:手术穿刺均一次获得成功。其中单通道取石130例,双通道取石21例,三通道石3例。一次取净结石115例,1周后经肾造屡管再行PCNL取石术39例。多发性肾结石未取净21例;结石取净133例,总取净率为86.36%。无大出血、血气胸、腹腔脏器损伤等严重并发症。结论:64层螺旋CT扫描加三维图像重建结合B超定位,可以最大限度地提高手术成功率,增加手术安全性,减少手术并发症,降低结石残留率,是经皮肾镜取石术中穿刺定位的理想组合。
Objective: To explore the value of 64-slice CT three-dimensional image reconstruction with B-ultrasound in percutaneous nephrolithotomy. Methods: One hundred and forty-four patients with nephrolithiasis underwent 64-slice spiral CT scans of the kidney and 58 of them underwent three-dimensional image reconstruction. All 154 patients underwent percutaneous nephrolithotomy under B-ultrasound. Results: Surgical puncture achieved success all at once. One single-channel stone 130 cases, double-channel stone in 21 cases, three-channel stone in 3 cases. One time to take net stones in 115 cases, one week after the renal tube made of repeated PCNL lithotomy in 39 cases. Multiple nephrolithiasis was not taken in 21 cases; stones were removed in 133 cases, the total removal rate was 86.36%. No major bleeding, blood pneumothorax, abdominal organ injury and other serious complications. Conclusion: 64-slice spiral CT scan combined with three-dimensional image reconstruction combined with B-ultrasound can maximize the success rate of operation, increase surgical safety, reduce surgical complications and reduce the residual rate of stone, is the percutaneous nephrolithotomy lithotripsy The ideal combination.