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目的探讨非增强螺旋CT定位联合C型臂在复杂肾结石微创治疗中的应用价值。方法对50例复杂肾结石患者术前模拟术中体位行螺旋CT扫描定位(CT组),术中联合C臂行微创经皮肾镜取石术,并与同期38例复杂肾结石直接C臂定位者(C臂组)进行比较。结果 CT组与C臂组比较,平均穿刺次数[(1.27±0.56)次/侧vs(2.28±1.19)次/侧,P<0.01]、通道建立时间[(5.51±2.31)min/侧vs(11.36±6.15)min/侧,P<0.01]、C臂使用次数[(2.53±0.77)次/侧vs(7.44±1.87)次/侧,P<0.01]及医生、患者术中X线暴露时间[(0.32±0.73)min/侧vs(0.53±0.28)min/侧,P<0.05&(0.43±0.72)min/侧vs(0.72±0.28)min/侧,P<0.01]均明显低于C臂组。结论非增强螺旋CT定位联合C臂微创经皮肾镜取石治疗复杂肾结石有助于提高经皮肾穿刺成功率,并减少术中C臂的应用、降低术中X线辐射量。
Objective To investigate the value of non-enhanced spiral CT and C-arm in minimally invasive treatment of complex renal calculi. Methods Fifty patients with complicated nephrolithiasis underwent CT scan in the preoperative simulation (CT group). The patients underwent minimally invasive percutaneous nephrolithotomy combined with C arm and 38 patients with complicated renal calculi Locator (C-arm group) for comparison. Results The mean number of punctures in CT group and C arm group was (1.27 ± 0.56) / side vs (2.28 ± 1.19) / side, P <0.01], and the time of establishing channel [(5.51 ± 2.31) min vs side vs 11.36 ± 6.15) min / side, P <0.01], the number of C-arm use was (2.53 ± 0.77) times / side vs (7.44 ± 1.87) times / side, P <0.01] (P <0.05), and (0.43 ± 0.28) min / side vs (0.72 ± 0.28) min / side, P <0.01] Arm group. Conclusion Non-enhanced spiral CT combined with C-arm minimally invasive percutaneous nephrolithotomy in the treatment of complex renal stones can help improve the success rate of percutaneous renal puncture and reduce the application of intraoperative C-arm and reduce intraoperative X-ray radiation.