三维重建技术在经皮肾取石术中的应用

目的探讨三维重建技术在经皮肾取石术(PCNL)中的应用,为结石的治疗提供理论依据。方法对西南医院2007年4月至2011年10月收治的192例肾结石患者按照随机数字表进行分组,各96例,均在超声定位下行PCNL,观察组术前接受CT图像三维重建,对比两组患者穿刺成功率、结石清除率及并发症等临床资料。结果两组患者年龄、性别、结石部位及结石横径等指标比较无统计学差异(P>0.05);观察组手术时间低于对照组,其结石清除率高于对照组,两组数据对比有统计学差异(P<0.05)。结论三维重建技术可直观、立体地显示肾盂、肾盏结构信息及结石的形状、大小、数量等情况,对PCNL穿刺通道的建立具有十分关键的辅助作用,可减少手术时间、提高结石清除率,且安全性良好,能够有效保证患者的预后和生活质量,值得临床广泛推广。

Application of 3D reconstruction technique in PCNL system

Objective To investigate the three-dimensional reconstruction technique in percutaneous nephrolithotomy（PCNL） in the application, and provide a theoretical basis for the treatment of calculus. Methods Our hospital in April 2007-2011 in October of 192 cases treated patients with kidney stones are grouped according to the random number table, all 96 cases, both in the B-positioning downstream PCNL, the observation group underwent preoperative CT image reconstruction, contrast two success rate in patients, stones take the net clinical data rate and complications. Results Observation group, 92 cases of kidney stones were detected, diagnosed 90 cases, sensitivity 95.8%, specificity of 97.8% in the control group, 43 cases of kidney stones were detected, diagnosed 33 cases, sensitivity 44.8%, specificity of 76.7% in the observation group sensitivity and specificity were significantly higher（P〈0.05）; observation operative time was lower than the control group, the stone clearance rate was higher, comparing two sets of data there was a significant difference（P〈0.05）. Conclusions Three-dimensional reconstruction technique can be intuitive, three-dimensional display of renal pelvis, calyces structure information and the stones of the shape, size, quantity and so on, has the auxiliary function is very critical to establish PCNL puncture channel, can reduce the operation time, improve the stone clearance rate, and the security is good, can effectively guarantee the prognosis and life quality, is worthy of clinical application.