输尿管结石126例临床X线分析

A Clinical and X - ray Analysis of Ureteric Calculus in 126 Cases

目的：探讨输尿管髂段结石移位和柱状形结石对肾功能的影响。材料与方法：回顾性分析经手术和临床X线确诊的输尿管结石126例；全部病例先用常规法IVP，27例加照延迟片。继用大剂量法6例，逆行造影24例，肾盂穿刺造影1例。结果：阳性结石104例，阴性结石22例。4例髂段结石移至骶髂关节外侧，距体中线约7cm～9cm。柱状形结石与圆形、梭形结石引起重度肾积水和不显影的对比，经X2检验，P值分别＜0．01和＜0．05，具有显著性差异。结论：腹部输尿管在结石引起慢性梗阻致重度扩张和重度肾积水时，易受牵拉、移位，在临床X线诊断工作中应引起注意。柱状形结石对肾功能影响最为严重，且不论其直径大小，保守治疗难以奏效，宜特别谨慎。

Purpose: The purpose of this paper was to study the displacement of calculus in iliae segment of the ureter and how cylindrical ureteric calculus affected the renal function. Materials and Methods: 126 Cases of ureteric calculus confirmed by surgery,clinic and X - ray were retrospectively studied. Routine IVP was performed in all cases, then additional delayed urogram were taken in 27 cases. IVP with large dose drip was done in 6 cases, retrograde pyelography in 24 cases and percuteneous pyelopuncture pyelography in 1 case. Results: Among 126 cases, 104 with nonradiolucent calculus and 22 with radiolucent calculus were detected. It was noted that ureteric calculi of iliac segment were displaced out of the sacroiliac joint, about 7 ~ 9cm from body mid - line in 4 cases. In comparison of severity of hydronephrosis, including nonvisualization of urinary tract, in the three different shapes of calculus (i. e, cylindrical,round and fusiform calculus), by x2 test, the results showed that (1) between the cylindrical and round calculi, P value was less than 0.01; (2) between the cylindrical and fusiform calculi, P<0.05, Thus there were significant statistic difference in both (1) and (2).Conclusion: Because ureteric calculus results in chronic obstruction, severe dilatation of the ureteric and hydronephrosis, abdominal ureter is prone to be pushed aside and displaced, so that the urologist and the radiologist should pay great attention to this. In spite of its size, cylindrical ureteric calculus will impair the renal function most severely, which is difficult to treat conservatively, and special caution should be taken.