结石CT值对输尿管软镜钬激光碎石效率影响的研究

Predictive value of Hounsfield unit on CT during flexible ureteroscopy with holmium laser lithotripsy

目的评估结石CT值对输尿管软镜钬激光碎石效率的影响。方法从2014年9月至2016年12月,在丹阳市人民医院行输尿管软镜钬激光治疗的肾结石患者98例,选取了其中大小、位置相似的72例患者,测量其术前CT值。根据CT值>1000 Hu或≤1000 Hu分为两组。比较两组的手术时间、术后并发症、术后3个月清石率情况等。结果低CT值组与高CT值组患者年龄、男女比例、结石大小差异无统计学意义(P>0.05)。两组手术时间分别为(82±13)min和(113±13)min,差异有统计学意义(P<0.01);并发症发生率分别为5%和14.7%,差异无统计学意义(P=0.334);术后3个月清石率分别为94.7%和91.1%,差异无统计学意义(P=0.955)。结论术前测量结石CT值,可以作为评估软镜联合钬激光碎石时间、碎石效率的指标之一,从而帮助泌尿外科医师把握手术难度和风险。

Objective To evaluate the effect of Hounsfield unit（Hu） value of flexible ureteroscopy with holmium laser lithotripsy. Methods From September 2014 to December 2016, a total of 98 cases of renal calculi in Danyang People＇s Hospital were collected, 72 patients among them with similar stone sizes and localization, and their preoperative Hu value were measured. According to the Hu value above 1000 Hu（1 000 Hu） or below 1000 Hu（1 000 Hu）, patients were divided into two groups. Then the operative time, complications, and the stone-free rate at postoperative 3 months were compared between the two groups. Results The age, male to female ratio and the stone size between the two group had no significant differences（P〉0.05）. The operative time of the two groups were（82±13） min and（113±13） min, respectively, which had significant differences（P〈0.01）; the incidence of complications were 5% and 14.7%, respectively, which had no significant differences（P=0.334）; Stone-free rate at postoperative 3 months were 94.7% and 91.1%, respectively, which had no significant differences（P=0.955）. Conclusions Preoperative measurement of stone HU value could be an indicator to assess time and effeciency of flexible and effeciency ureteroscopy with holmium laser lithotripsy efficiency, help the urologists to evaluate the difficulty and the risk of surgery.