3D可视化经皮肾穿刺规划及术中辅助定位引导PCNL的应用

陈远波; 张志甫; 陆剑君; 黄思源; 卢国平

doi:10.13201/j.issn.1001-1420.2021.12.010

3D可视化经皮肾穿刺规划及术中辅助定位引导PCNL的应用

- 广西医科大学附属民族医院泌尿外科(南宁, 530000)
基金项目:
广西卫健委科研计划项目（No：Z20201287）

详细信息

通讯作者: 陈远波,E-mail:cybchen@hotmail.com

中图分类号: R692.4

收稿日期: 2021-05-12

Application of 3D visualized percutaneous renal puncture planning and intraoperative assisted guidance in PCNL

- Department of Urology, Minzu Hospital, Guangxi Medical University, Nanning, 530000, China

More Information

Corresponding author: CHEN Yuanbo, E-mail: cybchen@hotmail.com

Received Date: 12 May 2021

摘要

摘要: 目的：介绍3D可视化经皮肾穿刺规划及术中辅助定位方法，并探索其在经皮肾镜取石术（PCNL）中的临床应用疗效。方法：回顾性分析2018年10月—2020年10月我中心同一医疗组采用PCNL治疗的160例肾结石患者，根据穿刺规划方法分为两组，3D规划组（76例）为采取3D穿刺规划及术中辅助定位，对照组（84例）为常规PCNL。比较两组患者穿刺定位时间、手术时间、出血量、术后结石清除率、并发症发生率、术后住院时间的差异。结果：3D规划组首个穿刺定位平均时间短于对照组（P<0.001）。3D规划组一期PCNL双通道穿刺比例显著大于常规组（23.6% vs.6.0%，P=0.001）。3D规划组一期结石清除率及总结石清除率显著大于对照组（85.5% vs.67.8%，P=0.009；92.1% vs.79.8%，P=0.026）；住院时间短于对照组[（4.7±1.0） d vs.（5.1±1.0） d，P=0.004]。两组在平均手术出血量、手术时间及术后并发症差异无统计学意义。结论：3D可视化经皮肾穿刺规划可提升PCNL穿刺通道的精准性、提高结石清除率，尤其适用复杂性肾结石合理规划一期多通道碎石，具有较好的临床应用价值。
- 三维 /
- 肾结石 /
- 经皮 /
- 穿刺规划
Abstract: Objective: To introduce the 3 D visualized percutaneous puncture planning and intraoperative assisted access method, and explore its clinical effect in percutaneous nephrolithotomy(PCNL).Methods: A total of 160 patients with renal stones treated with PCNL in our center from October 2018 to October 2020 were retrospectively analyzed. Of all cases were divided into two groups:3 D planning group(76 cases) who underwent 3 D preoperative puncture planning and intraoperative assisted guidance, and control group(84 cases) who received conventional ultrasound-guided PCNL. The puncture time, operative time, blood loss, stone-free rate, postoperative complication and postoperative hospitalization time were compared between the two groups.Results: The mean first tracts puncture time in the 3 D planning group was shorter than that in the control group(P<0.001). The proportion of bi-channel puncture in the 3 D planning group was significantly higher than that in the conventional group(23.6%vs. 6.0%,P=0.001). The one-stage stone-free rate and final stone-free rate in the 3 D planning group were significantly higher than those in the control group(85.5% vs. 67.8%, P=0.009; 92.1% vs. 79.8%, P=0.026), and the hospital stay was shorter than the control group[(4.7±1.0) d vs.(5.1±1.0) d, P=0.004]. There was no significant difference between the two groups in blood loss, operative time or postoperative complications.Conclusion: The 3 D visualized percutaneous puncture planning improves the accuracy of puncture access and stone free rate in PCNL. It was especially suitable for planning reasonable multiple tracts for complex renal stones.
- three-dimensional /
- renal stone /
- percutaneous /
- puncture planning

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