CT值测定在输尿管结石治疗方法选择中的应用

Application of the CT value in the choice of ureteral stones' treatment

目的探讨结石CT值在输尿管结石治疗方法选择中的应用。方法选择2009年1月～2011年12月沈阳市第五人民医院收治的输尿管中下段结石患者142例为研究对象,按输尿管结石CT值大小分成两组,CT值<700 HU组和CT值≥700 HU组,两组患者分别采用体外冲击波碎石术(ESWL)或输尿管镜下气压弹道碎石术(URSL)进行治疗,比较各组结石排出率、结石残留率和未改变率。结果采用ESWL治疗输尿管结石的患者中,CT值<700 HU组的结石排出率为75.0%,高于CT值≥700 HU组的46.9%,差异有统计学意义(P<0.05);采用URSL治疗输尿管结石的患者中,CT值<700 HU组的结石排出率为83.3%,CT值≥700 HU组的结石排出率为84.8%,差异无统计学意义(P>0.05);CT值<700 HU组的患者中,采用ESWL治疗的结石排出率为75.0%,采用URSL治疗的结石排出率为77.8%,差异无统计学意义(P>0.05);CT值≥700 HU组患者中,采用ESWL治疗的结石排出率为46.9%,低于采用URSL治疗的结石排出率(76.1%),差异有统计学意义(P<0.05)。结论输尿管结石CT值有助于选择合理的治疗方法,CT值低者采用ESWL治疗结石排出率较高,CT值高者采用URSL治疗效果较好。

Objective To investigate the application of CT values in the choice of ureteral stones＂ treatment. Methods 142 cases with lower ureteral stones from January 2009 to December 2011 in Shenyang Fifth People＇s Hospital were chosen as objects. All patients were divided into two groups by CT value, CT value 〈 700 HU group and CT value ≥ 700 HU group. Two groups of patients were randomly treated by extracorporeal shock wave lithotripsy （ESWL） or ureteroscopy pneumatic lithotripsy （URSL）, then the stone expulsion rate, the rate of residual stones and the rate of un- changing of the two groups were compared. Results In the patients who apply ESWL for ureteral stones, the stone ex- pulsion rate of CT value 〈 700 HU was 75.0%, higher than the stone expulsion rate of CT value ≥ 700 HU group, two groups had statistically significant differences （P 〈 0.05）. In the patients who apply URSL for ureteral stones, the rate of residual stones of CT value 〈 700 HU group was 83.3%, the rate of residual stones of CT value ≥ 700 HU group was 84.8%. Two groups had no statistically significant difference （P 〉 0.05）. Among the patients of CT value 〈 700 HU group, the stone expulsion rate of using ESWL treatment was 75.0%, the stone expulsion rate of using URSL treatment was 77.8%, two groups had no statistically significant differences （P 〉 0.05）. Among the patients of CT value ≥ 700 HU group, the stone expulsion rate of using ESWL treatment was 46.9%, the stone expulsion rate of using URSL treatment was 76.1%, two groups had statistically significant differences （P 〈 0.05）. Conclusion CT value of ureteral stones contributes to a reasonable choice of treatment methods. The stone expulsion rate of the low CT value is higher by ESWL treatment. The stone expulsion rate of the high CT value is higher by URSL treatment.