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目的通过与标准剂量螺旋CT比较,探讨低剂量螺旋CT定位在上尿路结石微创经皮肾镜碎石取石术(MPCNL)治疗中的应用价值。方法将78例拟行MPCNL治疗的上尿路结石患者,随机分为低剂量螺旋CT扫描定位组(低剂量组)和标准剂量螺旋CT扫描定位组(标准剂量组),于MPCNL前常规行俯卧位扫描定位,确定穿刺点、穿刺角度和深度。分别对两组患者螺旋CT有效辐射量、穿刺次数、皮肾通道建立时间、术中C臂应用次数、失血量及残石率进行比较。结果低剂量组螺旋CT有效辐射量约为标准剂量组的1/4(24.79%),差异有统计学意义(P<0.01),两组在平均穿刺次数、穿刺角度和深度、通道建立时间、失血量、术中C臂应用次数、残石率方面比较无统计学差异(P>0.05)。结论低剂量螺旋CT扫描替代标准剂量螺旋CT扫描行MPCNL定位安全、可行,且有利于降低患者围手术期X线的辐射剂量。
Objective To investigate the value of low-dose spiral CT in the treatment of upper urinary calculi with minimally invasive percutaneous nephrolithotomy (MPCNL) by comparing with standard-dose spiral CT. Methods 78 cases of upper urinary tract calculi treated with MPCNL were randomly divided into low-dose spiral CT scan group (low-dose group) and standard-dose spiral CT scan group (standard dose group) Bit scan positioning to determine the puncture point, puncture angle and depth. The effective radiation dose, the number of punctures, the time of establishing the renal access, the number of C-arm applications, the blood loss and the residual stone rate were compared between the two groups. Results The effective radiation dose of spiral CT in the low dose group was about 1/4 (24.79%) of the standard dose group, the difference was statistically significant (P <0.01). The average number of punctures, puncture angle and depth, channel establishment time, Blood loss, intraoperative C-arm application frequency, residual stone ratio was no significant difference (P> 0.05). Conclusion Low-dose spiral CT scan instead of standard dose spiral CT scan line MPCNL positioning safe and feasible, and help to reduce the radiation dose perioperative X-ray patients.