胰管结石最大长度和平均密度与体外震波碎石次数的相关性  

Association between maximum length and mean stone density of pancreatic duct and session number of extracorporeal shock wave lithotripsy

作　　者：凌立平 高霞 杨琰宁 石益海[1] 张春清 LING Liping;GAO Xia;YANG Yanning;SHI Yihai;ZHANG Chunqing(Department of Gastroenterology,Gongli Hospital of Shanghai Pudong New Area,Shanghai 200135,China;School of Gongli Hospital Medical Technology,University of Shanghai for Science and Technology,Shanghai 200093,China;Department of Gastroenterology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]上海市浦东新区公利医院消化科,上海200135 [2]上海理工大学公利医院医疗技术学院,上海200093 [3]山东第一医科大学附属省立医院消化科,山东济南250021

出　　处：《医学影像学杂志》2025年第1期74-78,共5页Journal of Medical Imaging

基　　金：上海市卫生健康委员会科研项目(编号:202140402)。

摘　　要：目的探讨CT检查胰管结石最大长度和平均密度(MSD)与胰腺体外震波碎石术(P-ESWL)治疗次数的关系。方法选取148例接受P-ESWL的慢性胰腺炎合并胰管结石患者,碎石术前均完善胰腺CT检查且碎石成功,并测量胰管结石最大长度和MSD。通过多因素分析P-ESWL治疗次数的影响因素。结果148例患者93例(62.84%)碎石治疗次数≤2;55例(37.16%)碎石治疗次数>2。多因素分析表明胰管结石最大长度增加,碎石治疗次数增加的风险增大(结石最大长度每增加5 mm:OR=6.906,P<0.001);胰管MSD增加,碎石治疗次数增加的风险增大(MSD每增加100 HU:OR=1.284,P<0.001)。结论胰管结石的最大长度和MSD是胰管结石P-ESWL治疗次数的影响因素,术前测量胰管结石的最大长度和MSD有助于预测胰管结石P-ESWL的治疗次数。Objectives To explore the association between maximum length and mean stone density(MSD)of pancreatic duct stones at computed tomography and session number of pancreatic extracorporeal shock wave lithotripsy(P-ESWL).Methods The clinical data of chronic pancreatitis patients with pancreatic duct stones who were admitted to Gongli Hospital of Shanghai Pudong New Area were retrospectively analyzed.A total of 148 cases completed pancreatic computed tomography(CT)before P-ESWL in our hospital,and pancreatic duct stones of these patients were successfully fragmented.The maximum length and MSD of stones were measured at CT,and the influencing factors of the session number of P-ESWL were explored by multivariate analyses.Results Among 148 patients,93(62.84%)patients received less than two(≤2)sessions of P-ESWL,while 55(37.16%)patients received more than two(>2)sessions of P-ESWL.Multivariate analyses showed that the risk of increased P-ESWL sessions raised as the maximum length of stones increased(for every 5 mm increase in maximum length:OR=6.906,P<0.001),and the risk of increased P-ESWL sessions also got bigger as the MSD of pancreatic duct increased(for every 100 hounsfield unit increase in MSD:OR=1.284,P<0.001).Conclusion The maximum length and MSD of pancreatic duct stones are the factors which influence the number of P-ESWL sessions.The measurement of maximum length and MSD of stones before lithotripsy is beneficial to predicting the number of P-ESWL sessions.

关 键 词：胰腺炎 结石 碎石术 体层摄影术 X线计算机 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学]