能谱CT结石成分分析技术在肾结石低能量体外冲击波碎石术中的临床应用

Clinical Application of Spectral CT Analysis of Stone Compositions in Low Energy Extracorporeal Shock Wave Lithotripsy of Kidney Stones

目的探讨分析能谱CT结石成分分析技术在肾结石低能量体外冲击波碎石术中的临床应用效果。方法方便选取该院2016年1月—2017年1月收治的经能谱CT结石成分分析技术评估后决定行低能量体外冲击波碎石术的肾结石患者40例作为实验组,同期收治的经常规CT检查后决定行体外冲击碎石术的肾结石患者40例作为对照组,观察比较两组的一次碎石成功率、轰击次数、最高工作电压以及术后严重并发症发生率等情况。结果两组患者的一次碎石成功率比较,实验组(75.0%)显著高于对照组(57.5%)(χ2=9.215,P<0.05)。两组患者的平均轰击次数比较,实验组[(1 236.8±35.6)次]显著低于对照组[(1 547.5±47.2)次](t=4.258,P<0.05)。两组患者的平均最高工作电压比较,实验组[(5.2±0.8)k V]显著低于对照组[(5.8±1.1)k V](t=4.012,P<0.05)。两组患者的术后严重并发症发生率比较,实验组(2.5%)显著低于对照组(12.2%)(χ2=4.586,P<0.05)。结论通过能谱CT结石成分分析技术准确分析肾结石成分,据此制定合理的低能量体外冲击波碎石术方案,可以有效提高手术的一次碎石成功率,同时降低术后严重并发症发生率,值得临床推广。

Objective This paper tries to investigate and analyze the clinical application effect of energy spectrum CT lithiasis component analysis technique in low energy extracorporeal shock wave lithotripsy of kidney stones. Methods 40 cases of kidney stones with low-energy extracorporeal shock wave lithotripsy were selected as the experimental group, and routine CT examinations were performed during the same period. After that, 40 patients with kidney stones who had undergone extracorporeal shock lithotripsy were convenient selected as the control group. The success rate of one stone crushing, the number of bombardments, the maximum operating voltage, and the incidence of postoperative serious complications were compared between the two groups. Results The gravel success rate of the two groups was significantly higher in the experimental group（75.0%） than in the control group（57.5%）（χ^2=9.215, P〈0.05）. The average number of bombardment times in the two groups was significantly lower in the experimental group [（1 236.8±35.6）times] than in the control group [（1 547.5±47.2）times]（t=4.258, P〈0.05）. The mean maximum working voltage in the two groups was significantly lower in the experimental group [（5.2±0.8）k V] than in the control group [（5.8±1.1）k V]（t=4.012, P〈0.05）. The incidence of serious postoperative complications in both groups was significantly lower in the experimental group（2.5%） than in the control group（12.2%）（χ^2=4.586, P〈0.05）. Conclusion Accurate analysis of the composition of kidney stones by spectral analysis techniques of CT spectroscopy stone composition, and the development of a reasonable low-energy extracorporeal shock wave lithotripsy program can effectively improve the success rate of primary lithotripsy and reduce the incidence of severe postoperative complications, which can be clinically promoted.