能谱CT在上尿路结石成分分析及术后预防复发中的应用  

Application of Energy Spectrum CT in Upper Urinary Tract Stone Composition Analysis and Prevention of Postoperative Recurrence

作　　者：周嘉明 姜贤 黄汉震 孙翔[2] ZHOU Jia-ming;JIANG Xian;HUANG Han-zhen;SUN Xiang(Department of Urology,Gaoxin Hospital of the First Affiliated Hospital of Nanchang,University,Nanchang 330096,China;Department of Urology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院高新医院泌尿外科,南昌330096 [2]南昌大学第一附属医院泌尿外科,南昌330006

出　　处：《实用临床医学（江西）》2023年第2期30-33,共4页Practical Clinical Medicine

基　　金：南昌市科技支撑计划项目(2020KJZCHTS-22)。

摘　　要：目的探索能谱CT对上尿路结石患者体内结石成分的分析及激光碎石术后预防结石复发的应用价值。方法按随机数字表法将选取的300例上尿路结石的住院患者分为观察组和对照组,每组150例。观察组术前行能谱CT扫描,对照组术前行普通CT平扫,患者均接受激光碎石治疗且术后腹部平片复查示结石基本清净。以红外光谱分析法为“金标准”,比较观察组能谱CT所得的结石成分,术后根据术前结石成分采取相应的预防措施。每3~6个月复查1次,随访时间为6个月至3年,平均22.5个月。比较2组术后结石复发率。结果观察组能谱CT所测结石成分与红外光谱结石分析法的相符率为86%(129/150)。术后随访期间观察组和对照组患者结石复发率分别为2%(3/150)、8%(12/150),2组比较差异有统计学意义(P<0.05)。结论能谱CT扫描操作方便,检测快捷,能在术前较精确地进行体内结石成分分析,不仅有助于明确结石的性质,对预防结石复发进行指导,还有助于选择适宜的治疗方法,更符合临床治疗的需求。Objective To explore the value of energy spectrum CT in the analysis of upper urinary tract stone composition and the prevention of stone recurrence after laser lithotripsy.Methods A total of 300 inpatients with upper urinary tract calculi were randomly assigned to receive either energy spectrum CT scan(observation group,150 patients)or routine CT scan(control group,150 patients)before operation.All the patients underwent laser lithotripsy,and postoperative abdominal radiographs showed that the calculi were basically cleared.The stone composition was analyzed in the observation group using infrared spectroscopy as the“gold standard”,and postoperative preventive measures were taken according to preoperative stone composition.The patients were re-examined every 3-6 months,and followed up for an average of 22.5 months(range,6 months to 3 years).Postoperative recurrence rate was compared between the two groups.Results In the observation group,the coincidence rate of energy spectrum CT and infrared spectroscopy for stone composition analysis was 86%(129/150).During the postoperative follow-up,the stone recurrence rate in the observation group(2%,3/150)was significantly lower than that in the control group(8%,12/150)(P<0.05).Conclusion Energy spectrum CT scanning is easy to operate and fast to detect,and can accurately analyze the composition of stones before surgery.It not only helps to clarify the nature of stones and provides guidance for preventing stone recurrence,but also helps to choose appropriate methods to meet the needs of clinical treatment.

关 键 词：能谱CT 上尿路结石 结石成分分析 术后复发 预防 

分 类 号：R699[医药卫生—泌尿科学]