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目的探讨螺旋CT(MSCT)三维重建成像在复杂性肾结石经皮肾镜双导管超声碎石术中的应用价值。方法将60例复杂性肾结石患者随机均分成研究组(A组)和对照组(B组)各30例,利用MSCT对全部患者肾结石进行非增强薄层扫描,获取肾结石及肾脏的影像学资料,并对研究组的肾结石进行三维重建成像,对两组的手术时间、术中出血量、穿刺通道数目、一期结石取净率等进行分析比较。结果 60例均顺利完成手术,无明显并发症。两组在手术时间(90±20)min VS(125±23)min、一次结石结石清除率93%VS 73%、穿刺通道数目(1.4±0.2)个VS(1.9±0.3)个,差异有统计学意义(P<0.05)。而术中失血量(105±10)ml VS(110±11)ml差异无统计学意义(P>0.05)。结论 MSCT三维重建成像可直观显示结石及周围的结构关系,能准确的选定经皮肾穿刺的位置,提高碎石取石效率,降低结石残留率,减少或避免术后并发症。
Objective To investigate the value of spiral CT (MSCT) three-dimensional reconstruction imaging in complex renal calculus percutaneous nephrolithotomy with dual-guided ultrasonic lithotripsy. Methods Sixty patients with complicated nephrolithiasis were randomly divided into study group (group A) and control group (group B), 30 cases each. Non-enhanced thin-layer scanning was performed on all patients with renal calculi by MSCT to obtain images of kidney stones and kidneys Learn the data, and the study group of kidney stones three-dimensional reconstruction imaging, the two groups of operation time, blood loss, the number of puncture channel, a stone removal rate analysis and comparison. Results 60 cases were successfully completed surgery, no significant complications. The time of operation was (90 ± 20) min VS (125 ± 23) min, the stone clearance rate of primary stones was 93% VS 73%, and the number of puncture channels was (1.4 ± 0.2) VS (1.9 ± 0.3) Significance (P <0.05). The intraoperative blood loss (105 ± 10) ml VS (110 ± 11) ml was no significant difference (P> 0.05). Conclusion MSCT three-dimensional reconstruction imaging can visually display the structure of the stone and the surrounding structure, can accurately select the location of percutaneous renal puncture, improve the lithotripsy efficiency, reduce the residual rate of stone, reduce or avoid postoperative complications.