断层红外光谱法与常规红外光谱法对较大体积泌尿系结石成分分析结果的一致性  

The consistency of tomographic infrared spectroscopy with conventional infrared spectroscopy for the analysis of the composition of larger-volume urinary calculi

作　　者：王碧霄 梁磊[1] 李晋庭 邢宇翔[2] 姬超岳 肖博[1] 蒋红梅 李建兴[1] Wang Bixiao;Liang Lei;Li Jinting;Xing Yuxiang;Ji Chaoyue;Xiao Bo;Jiang Hongmei;Li Jianxing(Department of Urology,Beijing Tsinghua Changgeng Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Engineering Physics,Tsinghua University,Beijing 100084,China)

机构地区：[1]清华大学附属北京清华长庚医院泌尿外科,清华大学临床医学院,北京102218 [2]清华大学工程物理系,北京100084

出　　处：《中华泌尿外科杂志》2022年第10期770-777,共8页Chinese Journal of Urology

摘　　要：目的比较断层红外光谱法与常规红外光谱法对较大体积泌尿系结石成分分析结果的一致性。方法采用清华大学附属北京清华长庚医院2019年1月至2021年6月收治的105例患者的术后泌尿系结石标本,其中肾结石81例(77.14%),输尿管结石16例(15.24%),膀胱结石8例(7.62%)。所有结石术前影像学检查测量最大径均≥0.8 cm。84例经皮肾镜碎石取石术和输尿管镜碎石取石术后标本,以结石碎块为主,采用常规红光谱法随机多点取样进行结石成分分析和复测。2020年11月1日后通过腹腔镜切开取石术或标准通道经皮肾镜取石术中利用网篮抓取获得的21例肾结石标本,术后测量最大径≥0.8 cm。根据术中所见,此21例取材时尽量选择包含完整分层构造的标本。此21例标本均分别采用常规红外光谱法和断层红外光谱法分析结石成分和复测。断层红外光谱法即取2个相对最大的同轴断面,断面垂直间距>2 mm,根据第1个断面的形态学分层进行多点取样,若断面无明显分层结构,则由中心向外周均匀样2~3处;若断面有明显分层结构,则依据分层,每层取样1处,每次取样材料分别进行红外光谱法分析,多点分析结果汇总为1次断层红外光谱法分析结果,取同一标本中另一同轴断面进行复测。记录21例标本结石成分的立体分布特征,比较常规红外光谱法、断层红外光谱法对同一样本结石成分分析结果一致性。结果本研究105例的常规红外光谱法成分分析结果一致率为56.19%(59/105),断层红外光谱法两次检测结果一致率为80.95%(17/21),两种方法的一致性差异有统计学意义(χ^(2)=4.447,P=0.035)。21例标本的常规红外光谱法结果一致率为38.10%(8/21),低于断层红外光谱法的一致率(χ^(2)=7.814,P=0.005)。在成分立体分布特征方面,5种常见结石成分的颜色和晶体形态各有特点,结石断面可观察到分层结构。结石成分相同时,结石仍可表�Objective To compare the consistency of tomographic infrared spectrum analysis with conventional infrared spectrum analysis for the composition analysis of large-volume of urinary stones in vitro.Methods Postoperative urinary stone specimens collected from 105 patients admitted to Beijing Tsinghua Changgung Hospital from January 2019 to June 2021 were analyzed,including 81(77.14%)kidney stones,16(15.24%)ureteral stones,and 8(7.62%)bladder stones.All stones measured≥0.8 cm in maximum diameter on preoperative imaging.Eighty-four specimens,which were mainly stone fragments,were collected from percutaneous nephrolithotomy and ureteroscopic lithotripsy.These 84 specimens were analyzed and retested for stone composition using conventional infrared spectrum analysis by random multiple sampling.Other 21 renal stone specimens were obtained by laparoscopic lithotomy or standard percutaneous nephrolithotomy after November 1,2020.These 21 specimens had a maximum diameter of≥0.8 cm measured postoperatively.Based on intraoperative observation,stone specimens with typical layered structures were chosed.Then,all 21 samples were analyzed and retested by conventional infrared spectrum analysis and tomographic infrared spectrum analysis,respectively.When using tomographic infrared spectrum analysis,we need to take two maximum cross sections with a vertical spacing of these sections>2 mm,then perform multiple points sampling according to the morphological stratification of the first section.If the section's structure was homogeneous,we equidistantly took 2 to 3 samples from the center to the periphery.Otherwise,every layer needed to take a stone sample according to the stratification.Putting all the results of one section together,we obtained complete tomographic infrared spectrum analysis data.Take another coaxial cross-section of the same specimen for retesting.We recorded the characteristics of the three-dimensional distribution of stone composition in 21 stone specimens.Meanwhile,we compared the consistency of the results of

关 键 词：尿路结石症 成分分析 红外光谱法 断层 草酸钙 

分 类 号：R699[医药卫生—泌尿科学]