免腹压大剂量静脉肾盂造影与超声检查在输尿管阴性结石体外碎石应用比较

A comparison study on thecurative effect between high-dose intravenous pyelography without abdominal pressure and ultrasonography for guiding ESWL in patients with negative ureteral calculi

目的探讨免腹压大剂量静脉肾盂造影定位对指导输尿管阴性结石体外冲击波碎石术(ESWL)临床价值。方法将56例输尿管阴性结石的患者按随机数字表法分为观察组和对照组,每组28例。观察组采用免腹压大剂量静脉肾盂造影定位技术联合ESWL治疗,而对照组采用超声定位技术联合ESWL治疗。比较两组碎石成功率,有效性及并发症发生率等情况。结果两组患者均能清晰显示结石大小,数目及位置信息。观察组经1次和3次ESWL治疗后,排石成功率分别为64.29%和89.29%,均高于对照组57.14%和82.14%,两者之间差异无统计学意义(P> 0.05)。观察组和对照组分别有1例和2例体外排石失败改行腔内碎石术治疗。观察组及对照组并发症分别有2例和3例,两组患者体外碎石失败率及并发症发生率的比较差异均无统计学意义(均P> 0.05)。结论免腹压大剂量静脉肾盂造影定位术联合ESWL治疗输尿管阴性结石,具有定位准确,成功率高,安全可靠的优点。

Objective To comparethe clinical effectiveness between high-dose intravenous pyelography without abdominal pressure and ultrasonography for guiding ESWL in patients with negative ureteral calculi.Methods 56 patients with ureteral negative calculi were recruited and divided into observation group and control group according to the random number table.The observation group was treated with ESWL guided using highdose intravenous pyelography without abdominal pressure,the control group was treated with ESWL guided using ultrasonography.The success rate,effectiveness and complication rate of the two groups were evaluated and compared.Results For both groups,the size,number and location of calculi were all clearly displayed.After 1 and 3 ESWL treatments,the success rates of stone removal in the observation group were 64.29﹪and 89.29﹪,respectively,both were higher than that of 57.14﹪and 82.14﹪in the control group,without statistical difference(P>0.05).1 case in the observation group and 2 cases in the control group were treated by intracavitary lithotripsy lastly,because the failure of extracorporeal lithotripsy.There were 2 cases and 3 cases underwent complications in the observation group and the control group,respectively.There was no statistically significant difference in the failure rate of extracorporeal lithotripsy and the incidence of complications between the two groups(P>0.05).Conclusion Large dose of intravenous pyelography without abdominal pressure combined with ESWL for treatment of negative ureteral calculi has the advantages of accurate localization,high success rate,safety and reliability.