上段输尿管结石体外冲击波碎石前行静脉尿路造影的价值  

Value of intravenous urography before extracorporeal shock wave lithotripsy in the treatment of proximal ureterai calculi

作　　者：桂西青[1] 郭振宇[1] 孙华宾[1] 练文飞[1] 殷放[2] 

机构地区：[1]中山大学附属第五医院泌尿外科,广东珠海519000 [2]中山大学附属第五医院普外科,广东珠海519000

出　　处：《中国医师进修杂志（外科版）》2008年第9期31-33,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨上段输尿管结石经体外冲击波碎石（ESWL）治疗前行静脉尿路造影（IVU）检查的价值。方法将腹部X线平片（KUB）证实为X线不透光的结石和超声检查无严重肾积水的单发上段输尿管结石100例患者随机分为两组，每组50例。IVU组ESWL前行IVU检查，对照组ESWL前不行IVU检查。观察ESWL治疗后并发症、结石清除率。结果IVU组有7例退出研究。对照组和IVU组结石清除率分别为86．0％（43150）和83．7％（36／43）；治疗成功率分别为94．0％（47，50）和95．3％（41／43）；并发症发生率分别为26．O％（13／50）和27．9％（12／43），两组比较差异均无统计学意义（P〉0．05）。结论KUB证实为X线不透光的结石和超声检查无严重肾积水的单发上段输尿管结石患者，ESWL治疗前无需行IVU检查，这样可减少放射线暴露、避免造影剂的毒副作用并节省医疗费用。Objective To study the impact ofpreprocedure intravenous urography （IVU） on the extracorporeal shock wave lithotripsy（ESWL） for proximal ureteral stones. Methods One hundred patients with solitary radiopaque proximal ureteral stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were allocated randomly to two treatment groups. IVU group （n=50） had WU before the start of ESWL, whereas patients in control group （n=50） underwent ESWL without WU. Postoperative success, the stone-free rates and complications were evaluated in both groups. Results Seven patients in WU group were excluded from the study. The success rate [95.3%（41/43） in IVU group vs 94.0% （47/50） in control group], stone-free rate [83.7% （36/43） vs 86.0% （43/50）] and complication rate [ 27.9%（ 12/43 ） vs 26.00/0（13/50） ]were similar in two groups （P 〉 0.05 ）. Conclusions It is not neces- sary to obtain an IVU for patients who have solitary radiopaque proximal ureteral calculi on plain radiographs with no severe hydronephrosis on ultrasonographic examination before scheduling them for ESWL, thus minimizing the cost, avoiding exposure to contrast medium, and reducing radiation exposure.

关 键 词：输尿管结石 静脉造影术 碎石术 超声检查 

分 类 号：R693.4[医药卫生—泌尿科学] R691.4[医药卫生—外科学]