LI Kai,ZHOU Ling,DAI Ting ting,et al.Clinical application research of minipercutaneous nephrolithotomy combine with CT urography to cure complicated renal calculi in pediatric[J].Journal of Clinical Pediatric Surgery,2013,12(03):229-231.[doi:10.3969/j.issn.1671—6353.2013.03.021]
CT尿路成像技术在儿童经皮肾镜碎石术中的应用
- Title:
- Clinical application research of minipercutaneous nephrolithotomy combine with CT urography to cure complicated renal calculi in pediatric
- Keywords:
- Urography; Kidney Calculi; Nephyrostomy; Percutaneous; Child
- 摘要:
- 目的探讨CT尿路成像技术在小儿B超引导下经皮肾镜碎石术治疗复杂肾结石的术前应用。方法对24例复杂肾结石患者在行经皮肾镜碎石术前，应用CT尿路成像三维重建技术，了解肾结石的部位、形状、结石分支的位置或方向，以及有无肾盏积水等，确定穿刺点、穿刺角度和深度，以提供最优穿刺路径，并与同期29例未行CTU评估的穿刺患儿比较结石清除率。结果24例使用CTU的患儿因为提供了最优穿刺路径，结石诊断率为100%，穿刺成功率100%，结石总取净率为79.4%，无输血病例，无腹腔脏器及胸膜损伤发生，较未行CTU评估穿刺的患儿结石一期清除率明显提高。结论应用CT尿路成像技术对肾结石进行评估，制定最佳穿刺路径，可减少穿刺损伤周围脏器的风险，减少手术出血。经皮肾镜碎石术前应用CTU能提高穿刺成功率，提高结石清除率，减少和避免术后并发症。
- Abstract:
- Objetive To investigate the utility of CT urography (CTU) reconstruction in preoperative of minipercutaneous nephrolithotomy under typeB ultrasound guidance in the treatment of complex renal calculi.MethodsThe 24 cases of complex renal calculi in patients with minimally invasive minipercutaneous nephrolithotomy line lithotripsy application of CT urography in the preoperative threedimensional reconstruction techniques to learn the location of kidney stones， shapes， position or direction of the branches of stones. and hydrocalyx etc.， to determine the puncture point， puncture angle and depth. to provide the best path for puncture. and the accuracy and effectiveness of 29 cases not underwent CTU was retrospective analysis.ResultsIn the 24 cases， CTU provided an advantage over conventional imaging in optimizing nephrostomy placement. All the case were punctured successfully. Stonefree rate was 100%，and total stonefree rate reached 79.4%.， all without blood transfusion， none of abdominal organs and pleural was injured.The stonefree at 1 session was significantly increased than group of not underwent CTU.ConclusionCT urography reconstruction technique evaluate in preoperative of minipercutaneous nephrolithotomy. Work out an advantage over conventional imaging in optimizing nephrostomy placement and decreases potential hazards in placing the track. MPCNL can be safe and effective， high stonefree rate and low complications with CTU.
参考文献/References:
1AlKandari A M， Jabbour M， Anderson A， et al.Comparative study of degree of renal trauma between Amplatz sequential fascial dilation and balloon dilation during percutaneous renal suegery in an animal model ［J］. Urology，2007，69(3);586—589.
2孟祥军，米其武，王华，等. CT 三维重建在经皮肾穿刺取石术中预防大出血的应用价值［J］.临床泌尿外科杂志， 2007 ， 22 (3) :187—189. 2Mi qiwu， Wang hua， et al. The value of three dimensional CT reconstruction in preventing severe hemorrhage with percutaneous nephrolithotomy［J］，Journal of Clinical Urology，2007， 22 (3) :187—189.）
3Olbert P，Weber J ， HegelA， et al. Combining Lithoclast and ultrasound power in one device for percutaneous neprolihotomy: invitro results of an ovel and highly effective technology［J］. Ur ol ogy， 2003， 61 (1) : 55—59.
4Patel U， Walkden RM， Ghani KR， et al.Threedimensional CT pyelography for planning of percutaneous nephrostolithotomy:accuracy of stone measurement，stone depiction and pelvicalyceal reconstruction ［J］. Eur Radiol，2009，19(5):1280—1288.
5Hegarty NJ， Desai MM. Percutaneous nephrolithotomy requiringmultiple tracts comparis on of morbidity with singletract procedures［J］. J Endourol， 2006，20 (10) : 753—760.
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