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目的:评估术前CTU在微通道经皮肾镜取石术(Mini-PCNL)中的临床价值。方法:收集2013年12月~2016年6月采用Mini-PCNL治疗的115例患者的临床资料并进行回顾性分析,根据术前影像学检查将患者分为CTU组和CT平扫组。比较两组患者手术时间、住院时间、术后结石清除率、出血等并发症并进行统计分析。结果:CTU组60例,CT平扫组55例。CTU组血红蛋白下降值明显低于CT平扫组[(3.67±2.27)g/L vs.(5.86±3.33)g/L],差异有统计学意义(P<0.05)。CTU组在手术时间[(100.63±18.26)min vs.(105.50±15.37)min],住院时间[(11.57±2.78)d vs.(12.39±2.85)d],一期结石清除率(81.6%vs.72.7%),二期结石清除率(91.6%vs.89.1%)等方面与CT平扫组相比较,差异均无统计学意义(P>0.05)。结论:采用CTU术前定位并结合术中彩超引导穿刺能减少PCNL术中出血量,在肾结石的治疗中具有较明显的有效性及安全性。
Objective: To evaluate the clinical value of preoperative CTU in microchannel percutaneous nephrolithotomy (Mini-PCNL). Methods: The clinical data of 115 patients treated with Mini-PCNL from December 2013 to June 2016 were retrospectively analyzed. The patients were divided into CTU group and CT scan group according to preoperative imaging examination. The operation time, hospital stay, postoperative stone clearance, bleeding and other complications were compared and statistically analyzed. Results: CTU 60 cases, CT scan group 55 cases. The decrease of hemoglobin in CTU group was significantly lower than that in CT scan group [(3.67 ± 2.27) g / L vs. (5.86 ± 3.33) g / L], the difference was statistically significant (P <0.05). The CTU group had significant difference in the time of operation [(100.63 ± 18.26) min vs. (105.50 ± 15.37) min], hospital stay [(11.57 ± 2.78) d vs. (12.39 ± 2.85) d] .72.7%), secondary stone clearance rate (91.6% vs.89.1%) and other aspects of CT scan group, the difference was not statistically significant (P> 0.05). Conclusion: The preoperative CTU positioning combined with intraoperative ultrasound-guided puncture can reduce the amount of PCNL intraoperative bleeding in the treatment of kidney stones have more obvious effectiveness and safety.