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3D 打印辅助经皮肾镜取石术治疗复杂性肾结石的疗效及安全性。

Efficacy and safety of 3D printing-assisted percutaneous nephrolithotomy in complex renal calculi.

机构信息

Department of Urology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, Shaanxi, China.

Department of Ultrasound Diagnostic, Tangdu Hospital, The Air Force Military Medical University, Xi'an, Shaanxi, China.

出版信息

Sci Rep. 2022 Jan 10;12(1):417. doi: 10.1038/s41598-021-03851-2.

Abstract

This study evaluated the efficacy and safety of 3D printing technology combined with percutaneous nephrolithotomy in the treatment of complex renal calculi. Ninety patients with complex renal calculi were randomly divided into a 3D printing group (45 patients) and a control group (45 patients). In the 3D printing group, a patient-specific 1:1 3D printing model was established based on the patient's thin-layer CT scanning data. A 3D printing model was used for preoperative communication between doctors and patients. Preoperative puncture training, channel design, residual stone prediction, and percutaneous nephrolithotomy were performed under the guidance of a 3D printing model and B-ultrasound. The control group was treated with the conventional B-ultrasound-guided puncture method. Results suggest that there was a statistically significant difference between the two groups (P < 0.05). The overall score of the doctor-patient communication objects in the 3D printing group was 19.32 ± 1.57 points, and in the control group, it was 14.51 ± 2.13 points. The operation time of the 3D printing group was 103.21 ± 13.49 min, and that of the control group was 126.12 ± 25.87 min. The calculi clearance rate of the 3D printing group was 96%, while that of the control group was 80%. The incidence of postoperative complications was 6.67% in the 3D printing group and 22.22% in the control group. Compared with traditional percutaneous nephrolithotomy, 3D printing technology combined with percutaneous nephrolithotomy can significantly enhance the effectiveness of doctor-patient communication, shorten operation time, reduce operation bleeding, improve the stone clearance rate, reduce the incidence of complications and shorten the length of hospital stay. The proposed method is thus a safe and effective method to treat complex renal calculi.

摘要

本研究评估了 3D 打印技术结合经皮肾镜碎石术治疗复杂性肾结石的疗效和安全性。90 例复杂性肾结石患者随机分为 3D 打印组(45 例)和对照组(45 例)。3D 打印组根据患者薄层 CT 扫描数据建立患者特异性 1:1 的 3D 打印模型。使用 3D 打印模型进行医患术前沟通、术前穿刺训练、通道设计、残石预测和经皮肾镜碎石术。对照组采用常规超声引导穿刺法。结果表明,两组比较差异有统计学意义(P<0.05)。3D 打印组医患沟通对象的总评分(19.32±1.57 分)明显高于对照组(14.51±2.13 分)。3D 打印组手术时间为(103.21±13.49)min,对照组为(126.12±25.87)min。3D 打印组结石清除率为 96%,对照组为 80%。3D 打印组术后并发症发生率为 6.67%,对照组为 22.22%。与传统经皮肾镜碎石术相比,3D 打印技术结合经皮肾镜碎石术能明显增强医患沟通效果,缩短手术时间,减少手术出血,提高结石清除率,降低并发症发生率,缩短住院时间。因此,该方法是治疗复杂性肾结石的一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d006/8748774/3bf6504ca1d1/41598_2021_3851_Fig1_HTML.jpg

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