超声检查对输尿管末端结石的诊断价值以及影响诊断结果因素的分析

The value of ultrasonography in the diagnosis of distal ureteral calculi and its influencing factors

目的探讨超声检查对输尿管末端结石的诊断价值及影响诊断结果的因素。方法2019年1月至2020年6月选取了在本院接受治疗的135例疑似输尿管末端结石的患者为研究对象。所有患者均行超声检查和CT检查,并以CT检查结果为标准,将输尿管末端结石定为阳性,将非输尿管末端结石和无结石定为阴性,计算超声检查诊断输尿管末端结石的敏感度、特异度、准确度。根据超声检查的诊断符合情况对影响检查结果的因素进行单因素分析。结果以CT检查结果为标准,超声检查对输尿管末端结石诊断的敏感度为89.8%(106/118),特异度为82.4%(14/17),准确率为88.9%(120/135)。Kappa一致性分析显示超声检查和CT检查结果的一致性较好(Kappa值=0.814,P<0.05)。单因素分析结果显示,超声检查输尿管末端结石的诊断结果与患者体质量指数(BMI)、膀胱容量有关,其中BMI越大,膀胱容量越小的患者更容易发生误诊、漏诊(P<0.05)。结论超声检查对输尿管末端结石具有较高的诊断效能,且BMI、膀胱容量是影响诊断结果的影响因素,对这类患者应当重点关注。

Objective To explore the diagnostic value of ultrasonography for distal ureteral calculi and the factors influencing the diagnosis results.Methods From January 2019 to June 2020,135 patients with suspected distal ureteral calculi in our hospital were selected as the research objects.All patients underwent ultrasound examination and CT examination.According to the results of CT examination,distal ureteral calculi were determined as positive,while non distal ureteral calculi and no calculi were defined as negative.The sensitivity,specificity and accuracy of ultrasound in the diagnosis of distal ureteral calculi were calculated.According to the diagnostic coincidence of ultrasonic examination,the single factor analysis was carried out on the influencing factors of the examination results.Results:The sensitivity,specificity and accuracy of ultrasonography in the diagnosis of distal ureteral calculi were 89.8%(106/118),82.4%(14/17)and 88.9%(120/135),respectively.Kappa analysis showed that the consistency of ultrasound and CT was high(Kappa=0.814,P<0.05).Univariate analysis showed that the diagnosis of distal ureteral calculi was related to BMI and bladder volume.The patients with higher BMI and smaller bladder volume were more likely to be misdiagnosed and missed diagnosis(P<0.05).Conclusion Ultrasonography has high diagnostic efficiency for distal ureteral calculi,and BMI and bladder volume are the influencing factors of the diagnosis results,which should be paid more attention to.