输尿管结石冲击波碎石前静脉尿路造影的必要性  

Is intravenous urography a prerequisite for shock wave lithotripsy of ureteral calculi

作　　者：桂西青[1] 孙华宾[1] 周少朋[2] 郭振宇[1] 练文飞[1] 苗永青[1] 

机构地区：[1]中山大学附属第五医院泌尿外科,珠海519000 [2]中山大学附属第五医院麻醉科,珠海519000

出　　处：《中国临床实用医学》2008年第12期70-70,71,72,共3页China Clinical Practical Medicine

摘　　要：目的探讨输尿管结石冲击波碎石（SWL）治疗前是否必须行静脉尿路造影（IVU）检查。方法选择212例病程为3个月、腹部平片（KUB）为不透X光和超声检查为非重度肾积水的单发输尿管结石患者随机两组，每组106例，IVU组SWL前行IVU检查，对照组SWL前不行IVU。观察SWL治疗后并发症、结石清除率。结果IVU组有18例退出研究。对照组和IVU组结石清除率分别为87．7％（93／106）和86．4％（76／88）；治疗成功率分别为94．3％（100／106）和93．2％（82／88）；并发症率23．6％（25／106）和25％（22／88），组间比较差异无统计学意义（P〉0．05）。结论病程在3月内、KUB为不透X光和超声检查为非重度肾积水的单发输尿管患者，SWL治疗前无需IVU检查，这样可减少放射暴露、避免造影剂的毒副作用和节省医疗费用。Objective To determine whether intravenous urography （IVU）is a prerequisite for shock wave lithotripsy（SWL） of ureteral calculi. Methods Two hundred twelve patients with solitary radiopaque ureteral stones on plain radiographs and no severe hydronephrosis on uhrasonographic examination and whose illness duration whithin 3 months were allocated randomly to two treatment groups. IVU group（ n = 106）had IVU before the start of SWL, whereas patients in the control group （ n = 106） underwent SWL without IVU. Postoperative success, stone-free rates and complications were evaluated in both groups. Results Eighteen patients in the IVU group were excluded from the study. The success rate [ 93.2% （ 82/88 ） in IVP group vs 94. 3% （ 100/106 ） in control group], stone-free rate [ 86.4% （ 76/88 ） vs87.7% （ 93/106 ） ], and complication rate [ 25% （ 22/88 ） vs23.6% （25/106） ] were similar in the two groups （ P 〉 0. 05 ）. Conclusion It is not necessary to obtain an IVU for patients who have solitary radiopaque ureteral calculi on plain radiographs with no severe hydronephrosis on uhrasonographic examination and whose illness duration whithin 3 months before scheduling them for SWL, thus minimizing the cost, avoiding exposure to contrast medium, and reducing radiation exposure.

关 键 词：输尿管结石 静脉尿路造影 冲击波碎石 腹部平片 超声检查 

分 类 号：R693.4[医药卫生—泌尿科学] R816.7[医药卫生—外科学]