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

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.

Assistance of Three-Dimensional Reconstruction of 64-slice CT Combining with B Ultrasound Localization in Percutaneous Nephrolithotomy

Objective：To study the value of three-dimensional reconstruction of 64-slice CT combining with B ultrasound localization in percutaneous nephrolithotomy. Methods：IS4 patients with renal lithiasis were tested by 64-slice CT, and 58 cases of them by three-dimensional reconstruction of 64 slice CT. By B ultrasound localization, all of them were treated by percutaneous nephrolithotomy. Results：With a puncturation , all operations were success, and single channel operations were 130 cases, two channel operations 21cases, three channel operations 3 cases. The stones were wiped by only one operation in 115 eases. After one week, percutaneous nephrolithotomy were done in 39cases again. Only in 21 cases with multiple renal lithiasis, the stones were not completely wiped. The calculus clearance rate was 86.36%. No serious complication was shown, such as hemorrhage, hemopneumothorax and injury of organ in abdominal cavity. Conclusions： The treatment of three-dimensional reconstruction of 64-slice CT combining with B ultrasound localization in percutaneous nephrolithotomy can elevate the success rate of operation, and increase the safety , decrease the complication, cut down the residual of stone. It is an ideal way of puncturing localization in percutaneous nephrolithotomy.