| 摘要: |
| 目的探讨结石成分及CT值对输尿管软镜碎石术（RIRS）疗效的影响。方法选择单个肾盂结石（直径10~30mm）且行RIRS的148例肾结石患者为研究对象。术前均行CT平扫检查明确结石大小并计算平均CT值。按照术后结石成分分析结果将一水草酸钙、磷酸钙结石归为硬结石组（A组，94例），二水草酸钙、磷酸镁铵和尿酸结石归为易碎结石组（B组，54例）。其中A组结石直径≤20mm为A1组（60例），＞20mm为A2组（34例）；B组结石直径≤20mm为B1组（32例），＞20mm为B2组（22例）。比较各组间平均CT值、结石清除率、手术时间、住院时间及并发症发生率。结果与A组比较，B组CT值明显较低（P＜0.05），结石清除率较高（P＜0.05）。各亚组结石清除率比较：B1组高于A1组（P＜0.05），B2组高于A2组（P＜0.05），B2组与A1组比较差异无统计学意义（P＞0.05）。4个亚组患者住院时间、术后并发症发生率比较，差异均无统计学意义（均P＞0.05）。结论结石成分是影响RIRS疗效的因素。结石直径相同而CT值低的患者行RIRS疗效佳，术前CT平扫测定CT值对手术疗效具有预测意义。 |
| 关键词: 输尿管软镜碎石术 结石成分 CT值 疗效 |
| DOI：10.12056/j.issn.1006-2785.2017.39.18.2017-278 |
| 分类号: |
| 基金项目:浙江省医药卫生科技项目（2014KYA231） |
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| Correlation of stone composition and HU value with efficacy of retrograde intrarenal surgery |
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the First People Hospital of Wenling
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| Abstract: |
| Objective To investigate the correlation of stone composition and HU value with the efficacy of retrograde intrarenal surgery(RIRS). Methods The clinical data of 148 adult patients with single renal pelvis stones(10-30mm) undergoing RIRS were retrospectively analyzed. All patients underwent CT plain scan before operation to determine the size of the stones and get the CT value. Calcium oxalate monohydrate and calcium phosphate stone were defined as hard stone, while calcium oxalate dihydrate, magnesium ammonium phosphate and uric acid stones were defined as crumbly stones. According the composition of stone patients were divided into two groups: group A with hard stone(n=94) and group B with crumbly stone (n=54). According to the size of stone patients were further divided into 4 subgroups: group A1 (n=60), group B1 (n=32) with stone diameter of 10-20mm, and group A2 (n=34) in group A, group B2 (n=22) with stone diameter of 20-30mm. The mean CT value, stone clearance rate, operation time, postoperative hospital stay and complication rate were compared among groups. Results The
HU value of group B was significantly lower and the stone clearance rate was higher than those of group A (both P＜0.05). The
stone clearance rate of B1 group was higher than that of A1 group(P＜0.05), the stone clearance rate of B2 group was higher than that of A2 group (P＜0.05). There was no significant difference between B2 group and A1 group (P＞0.05). Conclusion Stone composition and CT value are correlated with the efficacy of RIRS. Preoperative measurement of ct value of stone may predict the efficacy of RIRS. |
| Key words: RIRS Stone composition CT value Effect |
