CT预测泌尿系结石行气压弹道碎石易碎性的研究

Feasibility study of CT prediction of the fragileness of urinary calculi crashed by pneumatic lithotripsy in vitro

目的:探讨CT是否可以被用来预测泌尿系结石行气压弹道碎石(APL)时的易碎性,希望为临床上选择合理的治疗方法提供更多的科学依据。方法:选择2004年3月至2006年12月间120枚开放手术获得的结石,按同单位体积(mL)结石APL次数分成A、B、C3组。将3组的平均CT值分别进行比较。结果:A、B、C3组间的平均CT值差异均有统计学意义。结论:术前患者结石的平均CT值可以估计碎石的难易程度。选择治疗方案及时机时要综合分析结石部位、数量、自身操作水平、设备性能、患者耐受性等因素,在考虑到结石易碎性这一因素时,我们建议原则上对于≥1400HU且体积较大的结石宜选择开放手术;而≤920HU且结石体积不大时首选腔内碎石或体外震波碎石。

Objective To explore whether CT can be used to predict the fragility of urinary calculi crashed by pneumatic lithotripsy. Methods According to the per-unit volume（mL） impact number, 120 calcuis obtained from the patients underwent open surgery were randomly divided into three groups, including Group A （ 〈 300 times）, Group B （300 - 600 times） and Group C（ 〉 600 times）. Result There were significant differences of CT values among three groups （P 〈 0.01 ）. Conclusions According to the values of preoperative CT scan, the fragileness of crusing calculus needed to be crashed by pneumatic tithotripsy may be well prodicted. It is suggested that when average CT value of calculus is more than 1 400 HU and its volume is larger, open surgery is easily selected, or when average CT value is less than 920 HU and its volume is not very big, pneumatic lithotripsy may be better selected.