结石CT值对输尿管软镜取石术效率的预测价值

The Predictive Value of Stone CT Value for the Efficiency of Flexible Ureteroscopic Lithotomy

目的:分析结石CT值对输尿管软镜取石术效率预测价值。方法:回顾性分析重庆市长寿区人民医院行输尿管软镜取石术患者135例的病历资料,记录患者术前一般资料和结石数据(数量、体积和CT值)。术后3个月复查,根据结石清除情况将患者分为结石清除组和结石残留组,并进行单因素分析、多因素Logistic回归分析和受试者操作特征曲线(ROC曲线)分析。结果:单因素分析结果显示2组患者结石数量、结石体积和结石CT值差异均具有统计学意义(P<0.05);多因素Logistic回归分析结果显示结石数量≥2个、结石CT值升高均为输尿管软镜取石术术后结石残留的危险因素(P<0.05);ROC曲线分析结果显示结石CT值对输尿管软镜取石术术后结石残留的预测cut-off值为1092.75 HU,曲线下面积为0.725,95%CI为0.632~0.791,敏感度为51.91%,特异度为84.72%。结论:输尿管软镜取石术术后结石残留主要受结石数量、结石CT值影响,结石CT值用于预测输尿管软镜取石术术后结石残留诊断效能较高。

Objective:To analyze the predictive value of stone CT value for the efficiency of flexible ureteroscopic lithotomy.Methods:A retrospective analysis was conducted on the medical records of 135 patients who underwent flexible ureteroscopic lithotomy at Changshou District People's Hospital in Chongqing.The patients'general preoperative information and stone data(number,volume,and CT value)were recorded.After 3 months of postoperative follow-up,the patients were divided into stone clearance group and stone residue group based on the stone clearance status.Univariate analysis,multivariate Logistic regression analysis,and receiver operator characteristic(ROC)curve analysis were performed.Results:The univariate analysis showed that there were statistically significant differences in stone number,stone volume,and stone CT value between the two groups(P<0.05).The results of multivariate Logistic regression analysis showed that the stone number≥2 and elevated stone CT value were risk factors for residual stones after flexible ureteroscopic lithotomy(P<0.05).The ROC curve analysis results showed that the predicted cut-off value of stone CT for residual stones after flexible ureteroscopic lithotomy was 1092.75 HU,with an area under the curve of 0.725(95%CI:0.632-0.791),sensitivity of 51.91%,and specificity of 84.72%.Conclusion:The residual stones after flexible ureteroscopic lithotripsy are mainly influenced by stone number and stone CT value.Stone CT value has a high diagnostic efficacy in predicting residual stones after flexible ureteroscopic lithotripsy.