超声和非增强螺旋CT在输尿管镜钬激光碎石术中的对比研究  

Comparative study of ultrasound and non-contrast helical CT in holmium laser lithotripsy under ureteroscope

作　　者：林琳 冯岚 袁汝亮 陶阳 张汉标 云永子 洪海燕 LIN Lin;FENG Lan;YUAN Ruliang;TAO Yang;ZHANG Hanbiao;YUN Yongzi;HONG Haiyan(Department of Function,Sanya Central Hospital,Sanya,Hainan Province 572000,China)

机构地区：[1]三亚中心医院功能科,海南三亚572000

出　　处：《实用放射学杂志》2020年第11期1857-1860,1864,共5页Journal of Practical Radiology

摘　　要：目的探讨超声和非增强螺旋CT(NCHCT)对输尿管镜钬激光碎石术治疗泌尿系结石的对比研究.方法选取300例泌尿系结石患者,随机分为超声组和NCHCT组各150例,采用彩色多普勒超声测定结石位置、大小、声影伴随情况、闪烁伪像强度,采用NCHCT测定结石的位置、体积、CT值,术后记录钬激光碎石术总能量(TEL)使用情况,采用Spearman秩相关分析2组TEL与各结石参数的相关性,采用Logistic多元线性回归分析影响TEL的影响因素.结果在超声组中,肾结石、结石大小越大、结石伴声影、结石闪烁伪像强度越强的TEL明显升高,差异有统计学意义(P<0.05);在NCHCT组中,肾结石、结石体积越大和CT值越大的TEL明显升高,差异有统计学意义(P<0.05);Spearman秩相关分析示TEL与肾结石、结石大小、声影等级、闪烁伪像强度、结石体积、CT值呈正相关(P<0.001);Logistic多元线性回归分析显示肾结石、结石大小、结石闪烁伪像强度、结石体积和CT值是影响TEL的独立危险因素(P<0.05).结论泌尿系结石患者钬激光碎石术前接受超声和NCHCT检查测定结石参数与术后TEL存在明显相关性,为联合预测指导钬激光碎石术中TEL使用情况提供了基础,具有重要临床意义.Objective To investigate comparison of ultrasound and non-contrast helical CT(NCHCT)in the treatment of urinary calculi by holmium laser lithotripsy under ureteroscopy.Methods 300 patients with urinary calculus were randomly divided into 150 cases of ultrasound group and 150 cases of NCHCT group.The calculus location,size,acoustic shadowing level and twinkling artifact intensity were measured by color Doppler ultrasound.The calculus location,volume and CT value were measured by NCHCT.The total energy of lithotripsy(TEL)was recorded postoperatively.The correlation between TEL and calculus parameters were analyzed by Spearman's rank correlation analysis in the two groups.Logistic multiple linear regression analysis was used to analyze factors affecting TEL.Results In the ultrasound group,the renal calculus,the larger calculus size,the calculus with acoustic shadowing,and the stronger calculus twinkling artifact intensity of TEL was increased significantly(P<0.05);In the NCHCT group,the renal calculus,the larger the calculus volume and the higher the CT value of TEL was increased significantly(P<0.05);Spearman*s rank correlation analysis showed positive correlation between TEL and renal calculus,calculus size,acoustic shadowing level,twinkling artifact intensity,calculus volume and CT value(P<0.001);Logistic multiple linear regression analysis showed that renal calculus,calculus size,twinkling artifact intensity,calculus volume and CT value were independent risk factors for TEL(P<0.05).Conclusion The preoperative parameters examined by ultrasound and NCHCT are significantly correlated with the postoperative TEL.It is of great clinical significance to provide basis for combined prediction with guidance of TEL in holmium laser Jithotripsy.

关 键 词：超声 计算机体层成像 钬激光碎石术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R814.42[医药卫生—诊断学]