超声造影技术在非扩张肾脏集合系统肾结石患者经皮肾镜手术中的应用
Contrast-enhanced ultrasound technique is used in percutaneous nephroscopic surgery in patients with nephrolithiasis in the collecting system of the undilated kidney
陈海瑞 1李寿鹏 2田霁松 2沈东来 3王威 3罗渝昆 2李秋洋 2张旭 3麦海星1
作者信息
- 1. 解放军总医院第三医学中心泌尿外科医学部,北京 100039;安徽医科大学第五临床医学院,合肥 230032
- 2. 解放军总医院第一医学中心超声诊断科,北京 100853
- 3. 解放军总医院第三医学中心泌尿外科医学部,北京 100039
- 折叠
摘要
目的:对比超声造影(CEUS)和常规超声引导下应用于非扩张肾脏集合系统肾结石患者的经皮肾镜取石术(PCNL),评估CEUS引导的PCNL的有效性、安全性和可行性.方法:研究纳入解放军总医院第一医学中心收治接受PCNL的66例无肾积水或轻度肾积水肾结石患者,根据通道建立引导方法的不同分为CEUS引导组(33例)和常规超声引导组(33例).评估单针穿刺成功率、穿刺时间、穿刺次数、通道建立时间、手术时间、残石率等指标及术后并发症发生情况.采用SPSS22.0统计软件进行统计学分析.结果:相比于常规超声引导组,CEUS引导组首次穿刺成功率高(84.85%vs.63.64%,χ2=3.89,P=0.04)、穿刺时间短[(51.18±18.47)s vs.(63.21±23.79)s,t=-2.29,P=0.03]、手术时间短[(73.81±39.84)min vs.(113.44±51.99)min,t=-3.46,P<0.01],差异均有统计学意义.两组1个月残石率、血红蛋白(Hb)下降幅度以及穿刺次数比较,差异均无统计学意义(均 P>0.05).结论:CEUS引导下的 PCNL 可促进无肾积水患者的PCNL,有利于单针穿刺成功率高,穿刺时间短,手术时间短.可通过后续大样本量研究进一步确定其临床推广价值.
Abstract
Objective:To compare contrast-enhanced ultrasound(CEUS)and conventional ultrasound-guided percutaneous nephrolithotomy(PCNL)in patients with non-dilated collecting system kidney stones,evaluate the ef-fectiveness,safety,and feasibility of CEUS-guided PCNL in the First Medical Center of PLA General Hospital.Methods:This study included 66 patients with no hydronephrosis or mild hydronephrosis who underwent PCNL,they were divided into CEUS-guided group(33 cases)and conventional ultrasound-guided group(33 cases)accord-ing to the different methods to establish channel.The first puncture success rate,puncture time,puncture times,channel establishment time,operation time,residual stone rate and postoperative complications were evaluated.SPSS 22.0 statistical software was used for statistical analysis.Results:Compared with the conventional ultrasound-guided group,the CEUS-guided group had a higher first puncture success rate(84.85% vs.63.64%,χ2=3.89,P=0.04),shorter puncture time[(51.18±18.47)s vs.(63.21±23.79)s,t=-2.29,P=0.03],and shorter operation time[(73.81±39.84)min vs.(113.44±51.99)min,t=-3.46,P<0.01],with statistically significant differences.The 1-month stone residue rate,the decrease of hemoglobin(Hb)and puncture times had no statistically significant differences(all P>0.05).Conclusion:CEUS-guided PCNL facilitates percutaneous nephrolithotomy in patients without hydronephrosis,leading to a higher success rate of single puncture,shorter puncture time,and reduced over-all surgery time.Future large-scale studies are needed to confirm its value for broader clinical application.
关键词
超声造影/经皮肾镜/免人工肾积水/激光碎石取石Key words
contrast-enhanced ultrasound/percutaneous nephroscopy/free artificial hydronephrosis/laser lithotripsy引用本文复制引用
基金项目
国家自然科学基金面上项目(82173259)
北京市自然科学基金面上项目(7222232)
北京市科技计划(Z221100007422123)
出版年
2024
NETL
NSTL
万方数据