CT值与上尿路结石气压弹道碎石易碎生关系初探

目的 探讨非增强螺旋CT值与上尿路结石气压弹道碎石(PL)易碎性的关系,为临床上选择合理的治疗方法提供更多依据.方法 93例行PL治疗的上尿路结石患者,按结石PL次数分成A、B、C 3组.将3组的平均CT值分别进行比较分析.结果 A、B、C 3组间的平均CT值差异均有统计学意义(F=3.271,P=0.000).结论 术前患者上尿路结石的平均CT值可以估计碎石的难易程度.在选择治疗方案和时机时要综合分析结石部位、数量、医师操作水平、设备性能、患者耐受性等因素.在结石易碎性因素上,建议对于CT值＜900 HU且结石大小适宜(最大直径＜2 cm)者首选PL治疗,而CT值＞1200HU且体积较大(最大直径＞2.5 cm)或超过4枚的多发结石者应选择手术取石.

The relationship of CT value and the upper urinary tract stones pneumatic lithotripsy

Objective To investigate the value of non-enhanced spiral CT for upper urinary tract calculi pneumatic lithotripsy (PL) and provide more scientific basis for clinical treatments. Methods Ninetythree PL treatment of patients with upper urinary tract stones were divided into A, B, C three groups according to the PL times. The average CT values were comparatively analyzed. Results The average CT values have a statistically significant difference ( F=43.271, P=0.000 ). Conclusions Patients with upper urinary tract stones before the average CT value can be used to estimate the difficulty of lithotripsy. In the choice of treatment times and programs, it should be comprehensive analysis of stone location, quantity, level of operator, equipment performance, patient tolerance and other factors. For the fragile factor of stone, it recommend that when CT value＜900 HU and size of stones suitable (maximum diameter＜2 cm), when the preferred PL, when the CT value＞1200 HU and larger(maximum diameter＞2.5 cm) or more than four multiple stones surgery should be selected.