范 钰, 刘振华, 魏 强, 等.上尿路结石CT值预测结石成分和体外冲击波碎石术治疗的可行性.四川大学学报(医学版),2017,48(5):788-791
上尿路结石CT值预测结石成分和体外冲击波碎石术治疗的可行性
The Feasibility of CT Attenuation Value to Predict the Composition of Upper Urinary Calculi and Success Rate of
  
中文关键词:  CT 尿路结石 结石成分 体外冲击波碎石术
英文关键词:CT Urinary calculi Composition Shock wave lithotripsy
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中文摘要:
      目的 探讨上尿路结石平均CT值对结石成分和体外冲击波碎石术(ESWL)的冲击数和成功率的预测价值。方法 采集146例采用ESWL治疗上尿路结石的患者资料。患者在ESWL前完成CT检查,结石最大径线在2 cm以内,后采用红外光谱法对排出结石进行成分分析。ESWL治疗后随访1个月判断疗效。用相关性分析明确影响ESWL的冲击数和成功率的因素。结果 各种成分的结石CT均值各异,但相近值之间互有重叠,差异无统计学意义( P>0.05);含钙结石与不含钙结石相比较,其CT值较高( P<0.001)。不同年龄、性别和皮肤结石距离的患者间,结石的CT值、ESWL冲击数和成功率的差异无统计学意义。偏相关分析示结石CT值、结石长径均与ESWL冲击数呈中高度正相关( P<0.05),且其相关性按结石部位进行亚组分析(肾、输尿管)后仍存在;结石CT值、结石长径均与ESWL成功率呈低度负相关( P<0.05)。但亚组分析发现输尿管结石的CT值与ESWL成功率不存在相关性。结论 结石CT值不能完全准确预测结石成分,较高的结石CT值提示患者行ESWL治疗时需要更高的冲击数,但其不适用于预测ESWL成功率。
英文摘要:
      【Abstract】 Objective To explore the feasibility of CT attenuation value (CTvalue) to predict the composition of upper urinary calculi and the number of shock waves (NSW) and success rate (SR) of extracorporeal shock wave lithotripsy (ESWL). Methods A total of 146 patients with upper urinary calculi treated by ESWL were included. CT scan was performed before ESWL. Upper urinary calculi with the maximum diameters of less than or equal to 2 cm were included. Infrared spectroscopy was used to analyze the composition of calculi. The effect of ESWL was estimated at 1 month followup. The factors that influence NSW and SR of ESWL were analyzed by correlation analysis. Results The CTvalue of calcium calculi were larger than that of noncalcium calculi ( P<0.001). The differences of NSW, SR of ESWL and CTvalues of calculi between the patients with different ages, skintostone distances and genders were not statistically significant. The partial correlation analysis found that CTvalue and long diameter of calculi were positively correlated with the NSW ( P<0.05). This result was consistent in subgroup analysis (stone site: kidney or ureter). CTvalue and long diameter of calculi were negatively correlated with SR of ESWL ( P<0.05). However, the CTvalue of ureteral calculi was not correlated with SR of ESWL in subgroup analysis. Conclusions The power of CTvalue to predict upper urinary calculi composition is insufficient. Higher CTvalue suggests more NSW in ESWL, but CTvalue is not suitable to predict SR of ESWL.
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