基于CT三维重建技术的预置通道法经皮肾镜碎石术在治疗梗阻性肾、输尿管上段结石中的运用

doi:10.19558/j.cnki.10-1020/r.2020.05.005

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摘要 目的：探讨基于CT三维重建技术的预置通道法经皮肾镜碎石术在治疗梗阻性肾、输尿管上段结石中的运用。方法：回顾性分析2012年6月–2019年3月收治167例梗阻性肾、输尿管上段结石患者的临床资料,其中采用基于CT三维重建技术的预置通道法经皮肾镜碎石术治疗者31例,采用传统经皮肾镜碎石术治疗者136例。运用SPSS 25.0进行倾向性评分匹配,得到两组各31例进行比较。结果：基于CT三维重建技术的预置通道法经皮肾镜碎石术组（预置通道组）和传统经皮肾组患者基线资料具有可比性。预置通道组的结石清除率高于传统经皮肾镜组（P=0.029）,术中视野清晰度优于传统经皮肾镜组（P=0.037）,手术时间更短（P=0.001）,术后发热率更低（P=0.045）,术后血红蛋白下降值更少（P=0.012）,总住院时间差异无统计学意义（P=0.642）。结论：和传统经皮肾镜碎石术比较,基于CT三维重建技术的预置通道法经皮肾镜碎石术在治疗梗阻性肾、输尿管上段结石方面,具有减少手术并发症、缩短手术时间、提高结石清除率等优点,值得临床推广。

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	邵明峰
	邹建安
	徐久平

关键词 ：肾结石, 输尿管上段结石, CT三维重建, 经皮肾镜碎石术, 倾向性评分匹配分析

Abstract：Objective： To investigate the application of preset channel method based on CT 3D reconstruction technique used in the treatment of obstructive kidneys and upper ureteral calculi. Methods： The clinical data of 167 patients with obstructive renal and upper ureteral calculi in our hospital from June 2012 to March 2019 were analyzed retrospectively, and 31 cases were treated by percutaneous nephrolithotomy based on CT three-dimensional reconstruction technique, and 136 cases were treated by traditional percutaneous nephrolithotomy. We used the match of tendentious score by SPSS25.0 to choose 31 cases in each group. The clinical data were compared and analyzed. Results： The baseline data in preset channel group and traditional percutaneous nephrolithotomy group patients were comparable. The clearance rate of calculi was higher （P = 0.029）, the visual field clarity was better （P = 0.037）, the operation time was shorter （P = 0.001）, the fever rate was lower （P = 0.045）, and the hemoglobin drop value was less after the operation （P = 0.012） in the preset channel group than those in the traditional percutaneous nephrolithotomy group. There was no statistically significant difference in total hospital stay between two groups （P = 0.642）. Conclusion： Compared with traditional percutaneous nephrolithotomy, percutaneous nephrolithotomy based on CT three-dimensional reconstruction technique has the advantages of lower surgical complications rate, shorter operation time and higher calculi clearance rate in the treatment of obstructive renal and upper ureteral calculi, which is worthy of clinical popularization.

Key words： renal stone upper ureteral calculi three-dimensional CT reconstruction percutaneous nephrolithotomy tendency score matching analysis

收稿日期: 2019-08-18

ZTFLH:

R692.4

通讯作者: 邵明峰,sssmmmfff@126.com

引用本文:

邵明峰, 邹建安, 徐久平. 基于CT三维重建技术的预置通道法经皮肾镜碎石术在治疗梗阻性肾、输尿管上段结石中的运用[J]. 微创泌尿外科杂志, 2020, 9(5): 310-315.
SHAO Mingfeng, ZOUJianan, XU Jiuping. Application of preset channel method based on CT 3D reconstruction technique in the treatment of obstructive kidneys and upper ureteral calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 310-315.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1619.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I5/310

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