彩色多普勒超声联合 CT三维成像定位穿刺在经皮肾镜取石术中的应用价值

摘要

目的：探讨彩色多普勒超声联合CT三维成像定位穿刺在经皮肾镜取石术（ PCNL ）中的应用价值。方法复杂性肾结石患者74例，术前均行CT三维成像了解结石情况以定位，术中37例患者（观察组）采用彩色多普勒超声观察肾脏血流分布，实时引导穿刺，避开重要血管行PCNL；37例患者（对照组）采用普通B超引导下行PCNL。观察两组手术情况、结石清除率、术后并发症发生率及术后肾动脉血流动力学指征。结果与对照组相比，观察组手术时间短，血红蛋白损失量少，结石清除率高，术后肾主动脉血流速度快，并发症发生率及肾主动脉阻力指数低（ P均＜0．05）。结论彩色多普勒超声联合CT三维成像定位下行PCNL术，可避开重要血管，显著减少肾组织医源性损伤，提高PCNL术的成功率。%Objective To study the application of color Doppler ultrasound combined with CT three -dimensional imaging technology-guided puncture in percutaneous nephrolithotomy ( PCNL ) .Methods Seven-four patients with complex kidney calculi were examined with CT three-dimensional imaging technique before operation .Thirty-seven cases in the observation group received color Doppler ultrasound-guided puncture and PCNL ,avoiding damage to the import blood vessels;Thirty-seven cases in the control group received B-ultrasound-guided PCNL.To observe the characteristics of the operation , calculi clearance rate , incidence of postoperative complications and indications of postoperative renal aortic hemodynamics in two groups .Results The observation group showed shorter operation time,less hemoglobin loss,higher calculi clearance rate,faster postoperative kidney aortic blood flow ,lower incidence of postoperative complications and lower kidney aortic resistance index in contrast with the controls (all P<0.05).Conclusion PCNL guided by color Doppler ultrasound combined with CT three-dimensional imaging technology could avoid damage to the important blood vessels,significantly decrease kidney iatrogenic injury and improve the success rate of PCNL .