UWT对长径<1 cm的输尿管结石ESWL治疗失败的预测价值  

Predictive value of ureteral wall thickness at the site of ureteral calculi for failure of extracorporeal shock wave in treatment of ureteral calculi<1 cm

作　　者：康川疆 周艳[2] Kang Chuanjiang;Zhou Yan(Departemnt of Urology,Suining Central Hospital of Sichuan Province,Suinin 629000,China;Departemnt of Paediatrics,Suining Third People′s Hospital of Sichuan Province,Suinin 629000,China)

机构地区：[1]四川省遂宁市中心医院泌尿外科,遂宁629000 [2]四川省遂宁市第三人民医院儿科,遂宁629000

出　　处：《国际泌尿系统杂志》2024年第6期1097-1101,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨结石部位输尿管壁厚度(UWT)对长径<1 cm的输尿管结石经体外冲击波碎石术(ESWL)治疗失败的预测价值。方法回顾性分析2019年1月至2022年12月遂宁市中心医院收治的178例长径<1 cm的输尿管结石患者的临床资料,所有患者均接受ESWL治疗。根据治疗结果将患者分为ESWL成功组(118例)和ESWL失败组(60例)。采用单因素和多因素logistic回归分析ESWL失败的独立影响因素,绘制受试者工作特征(ROC)曲线分析结石部位UWT对长径<1 cm的输尿管结石经ESWL治疗失败的预测价值。结果ESWL成功组的结石最大上下径(MCD)、结石最大横径(MATD)、结石密度(MSD)、UWT均低于ESWL失败组(均P<0.05),肾积水程度较ESWL失败组更轻(P<0.05);多因素logistic回归分析显示UWT是长径<1 cm的输尿管结石经ESWL治疗失败的独立影响因素(均P<0.05)。ROC曲线分析结果显示,以2.64 mm为截断值,UWT预测长径<1 cm的输尿管结石经ESWL治疗失败的曲线下面积为0.824(95%CI:0.770~0.869),灵敏度和特异度分别为72.4%和73.1%。结论UWT在长径<1 cm的输尿管结石经ESWL治疗失败的预测中具有较高的临床价值。ObjectiveTo investigate the clinical value of ureteral wall thickness(UWT)at the site of ureteral calculi for failure of extracorporeal shock wave(ESWL)in treatment of ureteral calculi<1 cm.MethodsClinical data of 178 patients with ureteral calculi<1 cm admitted to Suining Central Hospital from January 2019 to December 2022 were retrospectively analyzed.All patients received ESWL treatment.Patients were divided into ESWL successful group(118 cases)and ESWL failed group(60 cases)according to treatment results.Univariate and multivariate logistic regression were used to analyze the independent influencing factors of ESWL failure,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of stone site UWT in the treatment failure of<1 cm ureteral stones by ESWL.ResultsThe maximum upper and lower stone diameter(MCD),maximum transverse stone diameter(MATD),stone density(MSD)and UWT in ESWL group were lower than those in ESWL group(all P<0.05),and the degree of hydronephrosis was less severe than that in ESWL group(P<0.05).Multivariate logistic regression analysis showed that UWT was an independent factor in the failure of<1 cm ureteral calculi treated by ESWL(all P<0.05).ROC curve analysis showed that with 2.64 mm as the cut-off value,the area under the curve of UWT predicting failure of ureteral stones<1 cm by ESWL was 0.824(95%CI:0.770-0.869),and the sensitivity and specificity were 72.4%and 73.1%,respectively.ConclusionsUWT has high clinical value in predicting the failure of ESWL treatment for ureteral calculi<1 cm.

关 键 词：输尿管结石 体外冲击波疗法 输尿管壁厚度 

分 类 号：R699[医药卫生—泌尿科学]