河北医科大学学报

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3D 虚拟内镜技术在输尿管软镜碎石术中的临床意义

  

  1. 河北医科大学第三医院泌尿外科,河北 石家庄 050051
  • 出版日期:2016-10-25 发布日期:2016-11-04
  • 作者简介:贾晓鹏( 1979- ),男,河北石家庄人,河北医科大学第三医院副主任医师,医学博士,从事泌尿外科疾病诊治研究。

The clinical value of 3D virtual endoscopy technology in ureteral soft lens lithotripsy in the treatment of kidney stones

  1. DepartmentofUrology , theThirdHospitalofHebeiMedicalUniversity,Shijiazhuang 050051 , China
  • Online:2016-10-25 Published:2016-11-04

摘要: [摘要] 目的 探索在输尿管软镜下肾脏结石碎石中应用 3D 虚拟内镜技术是否能够提高碎石效率及安全性。
方法 30 例肾结石患者按住院号末位数字编号,单号设定为 3D 虚拟内镜组(试验组)、双号为常规影像学检查组
(对照组)各 15 例, 2 组均应用 64 层螺旋 CT 对患者进行平扫 + 增强扫描,扫描结束后进行薄层重建。其中处理组
提取患者 CT 检查结果的 DICOM 格式文件,使用 Mimics 软件进行 3D 图形后处理,然后获得患者肾脏集合系统的
3D 虚拟内镜模型。观察 2 组手术者确定目标盏的时间、第一次系统探查肾脏各盏的时间、拔除导尿管时间、下床
活动时间以及清石率和并发症发生率。结果 30 例手术均顺利完成,处理组肾脏 3D 虚拟内镜模型均成功建立,肾
脏的集合系统、结石的大小和位置以及肾脏与结石的关系均显示良好。试验组确定目标盏时间、第一次系统探查
肾盏时间均短于对照组,试验组清石率高于对照组,试验并发症(出血、感染等情况)发生率低于对照组( P <0.05 ),
2 组恢复时间(拔出导尿管、下床活动时间等)、住院时间差异无统计学意义。结论 在输尿管软镜对肾脏结石碎石
过程中,应用 3D 虚拟内镜技术,能够提高碎石效率,并且可以降低术后并发症。

关键词: 肾结石, 输尿管软镜碎石术, 虚拟内镜技术

Abstract: [
Abstract ] Objective Toinvestigatetheapplicationof3Dvirtualendoscopytechnologyin
kidneystonepatientswhoacceptedsofturetermirrortreatmentandtofurtherdiscusswhetherit
canimprovetheefficiencyandsecurityoflithotripsy.Methods Thepatientsweredividedinto
researchgroupandcontrolgrouprandomlyaccordingtotheodevityofthelastnumberoftheID
number , theformerusing3Dvirtualendoscopyandthelatterusingtheconventionalradiographic
inspection.The30casesallaccepted64layersspiralCTscanwithnon-andenhancementandthin
layerwerereconstructedafterthescan.TheCTresultsofresearchgroupwerestoredbyDICOM
formatfile , whichlatertreatedby Mimicssoftwareinordertoobtainthepatients'kidney
collectingsystem3D modelsby3Dvirtualendoscopy.Thefollowingparametersin2groupsof
surgicalpatientswereobserved : thetimeofthetarget , thefirsttimethesystemtoexplorethe
timeofthekidney , thetimeofremovingthecatheter , thetimeofgettingoutofbedandrateof
stoneclearanceandincidenceofcomplications.Results Thirtycasesofsurgerywerecompleted
successfully.The3Dvirtualendoscopymodelsof15patientsinresearchgroupweresuccessfully
established , whichshowedclearlyimagesinthekidneycollectingsystem , thesizeandthe
locationofthestone , locationandthegoodrelationshipbetweenkidneyandstone.Thetimeto determinethetargetkidneycalicesandthefirsttimetodetecteverykidneycaliceswerelessin3D
virtualendoscopy models.Theremovingstonerateandthepostoperativecomplicationswere
significantlysuperiortotheconventionalradiographicinspectiongroup ( P <0.05 ) .Thereisno
statisticallysignificantdifferenceinrecoverytime ( suchasurethralcathetertime , postoperative
activitytime , etc ) and daysofhospitalization.Conclusion Theapplication of3D virtual
endoscopytechniquescanimprovetheefficiencyofgravelandreducepostoperativecomplications
intheprocessofusingsofturetermirrorinkidneystonepatients.

Key words: kidney calices, ureteral soft lens lithotripsy; , virtual endoscopy techniques