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目的:探讨CT尿路造影技术在复杂性肾结石PCNL术前评价的应用价值。方法:将复杂性肾结石患者60例分为实验组(30例,术前行64排螺旋CT尿路造影检查,进行图像重组,根据结石空间分布关系设计并建立PCNL通道进行腔内碎石取石术)和对照组(30例。采用同样方法进行治疗而术前只进行B超、IVP等常规检查,未行CT尿路造影检查)。结果:60例手术均获成功。实验组手术时间(82±32)min,术中出血量(88±42)mL,结石残留率为6.7%;对照组手术时间(142±40)min,术中出血量(101±51)mL,结石残留率为19.5%;两组比较,术中出血量两组无明显差异(P>0.05),实验组的手术时间以及结石残留率明显低于对照组(P<0.05)。结论:CT尿路造影能够清晰显示复杂性肾结石与肾动脉等重要周围结构的三维空间结构,有助于PCNL通道设计,提高了复杂性肾结石PCNL结石清除率和手术安全性。
Objective: To investigate the value of CT urography in the preoperative evaluation of complicated nephrolithiasis PCNL. Methods: Sixty patients with complicated nephrolithiasis were divided into experimental group (30 cases, preoperative 64-slice spiral CT urography, image reconstruction, according to the spatial distribution of stone design and the establishment of PCNL channel lithotripsy (Control group) and control group (30 cases) .But the same method was used for the treatment, and only B-mode ultrasound and IVP routine examination before operation were performed. CT urography was not performed. Results: All the 60 surgeries were successful. The operation time (82 ± 32) min, blood loss (88 ± 42) mL, and stone residual rate in the experimental group were 6.7%, 142 ± 40 min and 101 ± 51 mL in the control group , And the residual rate of stones was 19.5%. There was no significant difference in bleeding volume between the two groups (P> 0.05). The operation time and the residual rate of stone in the experimental group were significantly lower than those in the control group (P <0.05). CONCLUSION: CT urography can clearly show the three-dimensional structure of important surrounding structures such as complex renal calculus and renal artery, which is helpful for the design of PCNL channel and improving the clearance rate and operative safety of complex nephrolithiasis PCNL stone.