肾窦分离在急性输尿管结石中的诊断价值

Value of renal sinus separation in diagnosis of acute ureteral calculus

目的探讨肾窦分离以及腔内超声检查对输尿管结石的诊断价值。方法在急性腹绞痛伴有或不伴有血尿的急诊患者的超声检查中,对发现肾窦分离的患者,测量两侧肾窦分离的宽径,将有输尿管结石侧肾窦分离情况与无输尿管结石侧肾窦分离情况进行比较,并行输尿管全程扫查;对于膀胱充盈不佳、并排除中上段输尿管结石者,行经直肠(阴道)输尿管下段检查,确定有无输尿管结石,以及结石的部位和大小。结果发现输尿管结石83例,肾窦分离宽度(9.9±6.3)mm。46例输尿管结石的肾窦分离宽度≤10mm,占总数的55.4%;其中,输尿管上段结石占32.6%,中段占17.4%,下段占50.0%;输尿管患侧肾窦分离(6.1±4.0)mm,对侧(健侧)肾窦分离为(2.8±2.3)mm,平均增宽3.3mm。结论肾窦分离与输尿管结石关系紧密,即使<10mm的轻度肾窦分离对输尿管结石亦有着重要的提示作用。应用腔内超声对输尿管下段结石有重要的诊断价值,具有方便、快捷、准确、经济等优点。

Objective To explore the value of renal sinus separation and endoluminal ultrasound in diagnosis of acute ureteral calculus. Methods Uhrasonography was performed on patients with acute abdominal angina or blood in urine. The width of the bilateral renal sinus separation was measured and compared in patients with renal sinus separation. The upper, middle and lower segments of the bilateral ureters were scanned. In the patients without a full bladder and without calculus in upper and middle segments, transrectal or transvaginal ultrasound was applied to visualize the lower segment of the ureter. The existence , location and size of the calculus were determined. Results There were 83 cases of ureteral calculus, the average width of renal sinus separation was （9.9 ± 6.3） mm, In 46 cases, the width of renal sinus separation was ≤ 10 mm （46/83, 55.4% ）, including 32.6% in the upper segment, 17.4% in the middle segment , and 50.0%. in the lower segment. The average value of the renal sinus separation was （6.1 ± 4.0） mm, while （2.8 ± 2.3 ）mm on the opposite side, increasing 3.3 mm on average. Conclusion Renal sinus separation has close relationship to ureteral calculus, even less than 10 mm, it can greatly indicate ureteral stones. Endoluminal ultrasound has important value in diagnosis of lower ureter stone, which is fast, convenient, accurate and economical.