上尿路结石CT值预测结石成分在体外冲击波碎石术治疗中的临床应用

CT value of upper urinary calculi was used to predict the components of calculi and the feasibility of extracorporeal shock wave lithotripsy

目的:研究上尿路结石CT值预测结石成分在体外冲击波碎石术治疗中的临床应用价值。方法:上尿路结石患者84例,通过随机抽签法将其均分成实验组和对照组。对照组予以常规体外冲击波碎石术治疗,实验组则对患者的结石成分进行CT值预测,随后进行相应的体外冲击波碎石术治疗。分别对比两组以草酸钙、羟基磷灰石、胱氨酸、尿酸为主的结石CT值情况,比较两组在体外冲击次数、一次碎石成功率以及并发症发生率等方面的差异。结果:实验组与对照组以草酸钙、羟基磷灰石、胱氨酸、尿酸为主的结石CT值均呈逐渐下降趋势,且经单因素方差分析可得:各组间对比差异有统计学意义(均P<0.05)。实验组与对照组的体外冲击次数分别为(1160.23±164.08)次、(1483.18±192.74)次,实验组更低(P<0.05)。实验组与对照组的一次碎石成功率分别为90.48%(38/42)、73.81%(31/42),实验组更高(P<0.05)。实验组与对照组的并发症发生率分别为4.76%(2/42)、19.05%(8/42),实验组更低(P<0.05)。结论:在上尿路结石CT值预测结石成分的基础上予以体外冲击波碎石术治疗,有利于减少体外冲击次数,提高一次碎石成功率,降低并发症发生风险。

Objective:To study the CT value of upper urinary calculi to predict the components of calculi and analyze the feasibility of extracorporeal shock wave lithotripsy.Methods: 84 cases of upper urinary stone patients admitted to were selected as observation objects, and all were divided into experimental group and control group by random lottery. The control group was treated with conventional extracorporeal shock wave lithotripsy, while the experimental group was treated with extracorporeal shock wave lithotripsy after the prediction of the CT value of the stone components. CT values of the two groups with calcium oxalate, hydroxyapatite, cystine and uric acid as the main stones were compared, and the differences in the number of in vitro shocks, the success rate of lithotripsy and the incidence of complications between the two groups were compared.Results: CT values of calcium oxalate, hydroxyapatite, cystine and uric acid in the experimental group and the control group presented a gradually decreasing trend, and the results of one-way anova showed that the differences between the groups were statistically significant(all P<0.05).The number of in vitro shocks in the experimental group and the control group was(1160.23±164.08) and(1483.18±192.74) respectively, the former was lower(P<0.05).The success rate of primary lithotripsy in the experimental group and the control group were 90.48%(38/42) and 73.81%(31/42), respectively, the former was higher(P<0.05). The incidence of complications in the experimental group and the control group were 4.76%(2/42) and 19.05%(8/42), respectively, the former was lower(P<0.05).Conclusion:The application of extracorporeal shock wave lithotripsy on the basis of CT value of upper urinary calculi to predict the components of calculi is highly feasible, which is beneficial to reduce the number of extracorporeal shock, improve the success rate of primary lithotripsy and reduce the risk of complications.