CT肾血管成像在经皮肾镜取石术中的应用价值

目的探讨螺旋CT肾血管成像在经皮肾镜取石术中的应用价值。方法 2010年5月至2011年8月,对32例肾结石（8 mm×13 mm～26 mm×62 mm,平均27 mm×36 mm）患者先行CT肾血管成像,制定手术方案,然后行经皮肾镜取石术。结果多发性肾结石23例,鹿角形肾结石9例,其中先天或功能性孤立肾结石5例。CT肾血管成像可提供肾血管的清晰图像,与常规图像相比较,有利于选择无血管区域进行穿刺。32例患者均成功行经皮肾镜取石术,结石清除率为89.7%,无术中术后大出血发生,无需要输血者。结论经皮肾镜取石术并发出血应以预防为主,CT肾血管成像可准确显视结石部位和肾血管分布,便于确定经皮肾穿刺部位,避免术中术后大出血的发生。

Significance of CT renal angiography in percutaneous nephrolithotomy

Objective To evaluate the significance of CT renal angiography(CTA) in percutaneous nephrolithotomy(PCNL).Methods 32 patients with renal calculi(8 mm×13 mm-26 mm×62 mm,mean 27 mm×36 mm) underwent CT renal angiography in our hospital during May 2010 to Aug.2011 and then received percutaneous nephrolithotomy.Results Of the 32 cases,23 had multiple calculi,9 staghorn calculi,and 5 congenital or functional solitary kidney calculi.CT renal angiography provided a good map of renal vascular,which had an advantage over conventional imaging in optimizing nephrostomy placement.All patients had percutaneous nephrolithotomy successfully,the stone-free rate was 89.7%,and no patients suffered severe hemorrhage or needed blood transfusion.Conclusions Prevention is very important for hemorhage during percutaneous nephrolithotomy.CT renal angiography enables an accurate prediction of the site of stones and optimal site(s) for placing the percutaneous track,and helps prevent severe hemorrhage.