体外冲击波碎石对高密度输尿管结石治疗效果的影响因素分析

Prediction of stone-free rates after extracorporeal shockwave lithotripsy for treatment of high-density ureteral stones

目的探讨影响体外冲击波碎石(ESWL)治疗高密度输尿管结石疗效(CT值>1000 HU)的影响因素。方法回顾性收集2015年6月至2020年6月在北京大学首钢医院诊断CT值>1000 HU的单发输尿管结石,同时行ESWL治疗患者的临床资料,分析第一次体外碎石后的疗效和影响因素。结果65例患者纳入研究,平均结石大小为(10.63±3.24)mm,平均结石密度(CT值)1202±126 HU,碎石成功率为63.1%,结石大小是影响ESWL治疗效果的独立影响因素(OR=1.586,95%CI=1.162~2.166,P=0.004)。ROC曲线分析显示,预测ESWL疗效的结石大小临界值是1 cm。结论对于CT值>1000 HU的输尿管结石,结石大小是影响ESWL疗效的独立预测因素,其中≤1 cm结石的碎石成功率达84.8%。

Objective To identify the influencing factors of extracorporeal shockwave lithotripsy(ESWL)in the treatment of high-density ureteral calculi(CT value>1000 HU).Methods Clinical data of single ureteral calculi with a CT value>1000 HU diagnosed at Peking University Shougang Hospital from June 2015 to June 2020 were retrospectively collected,and the efficacy and influencing factors of the first external lithotriptomy were analyzed.Results Sixty-five patients were included in the study.The average stone size was(10.63±3.24)mm,the average stone density(CT value)was 1202±126 HU,and the success rate of lithotripsis was 63.1%.Stone size was an independent factor affecting the therapeutic effect of ESWL(odds ratio=1.586,95%confidence interval:1.162~2.166,P=0.004).ROC analysis showed that the critical value of stone size for predicting ESWL efficacy was 1 cm.Conclusion For ureteral calculi with a CT value>1000 HU,stone size is an independent predictor of ESWL efficacy,and the success rate of ESWL for calculi≤1 cm was 84.8%.