急性输尿管结石伴肾包膜下积液的超声分析及临床意义

Ultrasonographic analysis and clinical value of acute ureterolithiasis with dropsy under capsula fibroso

目的:探讨急性输尿管结石合并肾包膜下积液的原因及临床意义。方法:对我院693例超声诊断为急性输尿管结石的病例进行回顾性分析,观察肾包膜下积液的程度以及同输尿管结石部位、大小、肾积水的关系。结果:①693例急性输尿管结石并发肾包膜下积液者共54例(占7.8%),发病时间均在48h之内。②肾包膜下积液超声图像上表现为肾包膜下新月形、三角形、带状等液性暗区,液性暗区宽约2～17mm,平均约8mm。③输尿管结石直径约4～18mm,以下段多见,肾积水宽约8～21mm。结论:急性输尿管结石可引起肾包膜下积液,其原因为肾盂内压升高、尿液外渗所致;肾包膜下积液与输尿管结石部位、大小及肾积水程度无关;超声检查可以及时明确诊断,为临床提供诊疗依据。

Objective：To investigate the etiology and clinical significance of acute ureterolithiasis with dropsy under capsula fibroso. Methods：Six hundred and ninety-three cases of acute ureterolithiasis diagnosed with ultrasound were collected and analyzed retrospectively to observe the relationship between the degree of dropsy under capsula fibroso and the ureteral calculi location, the ureteral calculi size, and uronephrosis. Results： （1） 54 of 693 acute ureterolithiaSis cases were complicated by varying degrees of dropsy under capsula fibroso within 48h, the percentage was about 7.8%. （2）The dropsy showed like triangle, crescent, and strap fluid sonolucent areas on the ultrasound pattern, the width of the fluid sonolucent area ranging from 2 mm to 17 mm, the average width was about 8 mm. （3）The ureteral calculi were about 4 mm to 18 mm in diameter. In most cases, the ureteral calculi located in the lower ureter. The uronephrosis width ranged from 8 mm to 21 mm. Conclusion： Acute ureterolithiasis can cause varying degrees of dropsy under capsula fibroso because of the urine leakage induced by the increase of the pelvis pressure. Dropsy under capsula fibroso has no connection with the location and the size of ureteral calculi and uronephrosis. Ultrasound can timely diagnose the ureteral calculi and dropsy under capsula fibroso, and provide the evidences for clinical diagnosis and treatment.