能谱CT对肾结石原子序数测定与CT值测定在体外震波碎石中的临床应用研究  

Clinical application of spectroscopic CT in determination of kidney stone atomic number and CT value in extracorporeal shock wave lithotripsy

作　　者：石才汇 毕革文[2] Shi Caihui;Bi Gewen(Guangxi University of Chinese Medicine,Nanning 530001)

机构地区：[1]广西中医药大学,南宁530001 [2]广西中医药大学第一附属医院泌尿外科,南宁530023

出　　处：《陕西医学杂志》2018年第11期1383-1386,共4页Shaanxi Medical Journal

基　　金：广西自治区卫生和计划生育委员会科研项目(S201410-04);广西中医药大学2016年研究生教育创新计划资助项目(YJS201634)

摘　　要：目的:研究能谱CT对肾脏结石原子序数与CT值测定在体外震波碎石中的应用价值。方法:选取80例具备体外冲击波碎石治疗适应证的单发肾结石患者作为研究对象,以自愿接受体外冲击波碎石术为原则,根据研究设计方案分为A、B两组,A组为对照组:按目前常规通过KUB、B超、普通CT扫描确诊肾结石患者40例。B组为观察组:采用能谱CT诊断并测定出结石原子序数,判断出结石成分,从中筛选出易于体外冲击波碎石击碎的病例40例。给予相同能量和频次的体外冲击波碎石治疗,分别统计两组患者年龄、体重、结石部位、结石大小。B组需记录不同成分结石原子序数和CT值。评估A、B两组一次性碎石成功率;碎石后并发症总发生率。结果:观察组一次碎石后总有效率为90%高于对照组的75%(P<0.05);对照组并发症发生率为27.5%高于观察组的10%(P<0.05)。观察组结石成分为尿酸、磷酸镁铵及二水草酸钙结石共40例,其中尿酸结石8例,平均原子序数(6.94±2.84),平均CT值(554.25±67.13)Hu;磷酸镁铵结石14例,平均原子序数(8.33±1.98),平均CT值(751.16±153.12)Hu;二水草酸钙结石18例,平均原子序数(9.21±2.78),平均CT值(905.46±87.43)Hu。观察组易碎结石的平均原子序数和平均CT值之间的比较,差异有统计学意义(P<0.05)。结论:碎石前判定结石成分和评估结石硬度可提高碎石成功率并减少碎石后并发症。ObjectiveTo study the application value of energy spectrum CT in the determination of the atomic number and CT value of kidney stones in extracorporeal shock wave lithotripsy. Methods： Eighty patients with single-shot kidney stones with extracorporeal shock wave lithotripsy indications from March 2016 to June 2017 were selected as subjects. Voluntary external shock wave lithotripsy was adopted as the principle. The program was divided into two groups, A and B. Group A was the control group： 40 patients with kidney stones were diagnosed by KUB, B-ultrasound and ordinary CT scan. Group B was the observation group： using energy spectrum CT to diagnose and determine the atomic number of stones, determine the composition of stones, and selected 40 cases that were easily broken by extracorporeal shock wave lithotripsy. The same energy and frequency of extracorporeal shock wave lithotripsy were given, and the age, weight, stone location and stone size of the two groups were counted. Group B needs to record the atomic number and CT value of different components. Evaluate the success rate of one-time lithotripsy in groups A and B; the total incidence of complications after lithotripsy.Results： The total effective rate was 90% in the observation group and 75% in the control group（ P 〈0.05）. The complication rate in the control group was 27.5%,The observation group was 10%（ P 〈0.05）.Observed the composition was divided into uric acid, ammonium magnesium phosphate and calcium silicate calcium dihydrate in a total of 40 cases, including 8 cases of uric acid stones,the average atomic number of（6.94±2.84）,the average CT value of（554.25±67.13）Hu,14 cases of magne sium ammonium phosphate stone,the average atomic number （8.33±1.98）,the average CT value was （751.16±153.12）Hu,18 cases of calcium oxalate dihydrate, the average atomic number was （9.21±2.78）,and the average CT value was （905.46±87.43）Hu.The comparison between the mean atomic number and the mean CT value of the fragile s

关 键 词：肾结石 碎石术 治疗结果 @原子序数 @CT值 

分 类 号：R692.4[医药卫生—泌尿科学]