B超检查对输尿管结石合并肾盂积水的诊断分析

B-mode Ultrasonographic Diagnosis and Analysis of Ureterolith Complicated with Hydronephrosis

目的 探讨输尿管结石的大小及发生部位与其所致的肾盂积水程度之间关系。方法 用二维超声对各段输尿管结石进行详细扫查 ,测量结石的大小、部位以及肾盂积水的程度 ,分析结石大小、部位与肾盂积水之间的关系。结果 7例重度肾盂积水中 ,5例结石长径 >1 0 mm,均位于输尿管第一狭窄处 ;2例结石长径在 4～ 1 0 mm,位于输尿管腹段。 1 8例中度肾盂积水中 ,1 0例结石长径 4～ 1 0 mm,8例结石长径 >1 0 mm;1 7例位于输尿管腹段 ,1例位于输尿管的盆段 ,尤以第一狭窄处为多 ,占 1 2例。 2 6 5例轻度肾盂积水中 ,1 6 1例结石长径<4 mm,占 5 5 .5 % ,输尿管全长均可发生 ,以膀胱壁内段为多 ,占 4 3.5 %。 2 5 5例结石发生于三个生理性狭窄处 ,占 87.9% ;35例结石发生于非生理性狭窄处 ,占 1 2 .1 %。结论 超声探测输尿管结石时 ,通过先对肾盂积水程度的判断 ,可初步估计输尿管结石的大小及发生部位 ,为快速。

Objective To evaluate the relationship between the size and position of ureterolithes and the degree of hydronephrosis.Methods We Investigated ureterolithes in all ureter sections with 2 D echocardiography and measured the size and position of ureterolithes and the degree of hydronephrosis.The relationship was analysed between the size and position of ureterolithes and the degree of hydronephrosis.Results Seven patients were with serious hydronephrosis.Among them,we found in 5 cases,the lith longitudinal diameter>10 mm and the position were all at the first narrow part of the uneter;in 2 cases,the lith longitadinal diameter,4～10 mm located at the abdominal part of the ureter.Among 18 patients with moderate hydronephrosis.in 10 cases the lith diameter was 4～10 mm;in 8 cases,the diameter was>10 mm;in 17 cases,the location was at the abdominal part of the ureter;in 1 case,it located at the pelvic part of the ureter.In most cases(totally 12 cases)the lith located at the first narrow part .Among the 265 patients with mild hydronephrosis,161 caes had the lith diameter<4 mm(55 5%).The ureterolith occurred at all sections of the ureter and urinary bladder mostly at the internal wall portion of 43 5%.Among all 265 patients with hydronephrosis,255 cases had ureterolith located at the three physiologic parts of the ureter,87 9%;35 cases had ureterlith at other parts of the ureter,12 1%.Conclusions Firstly,by ultrasonographic judging the degree of hydronephresis,we can initially estimate the size and position of the ureterolith which can offer references for quick and accurate diagnosis of the ureterolithes.