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作 者:徐艳中 赵浩延 王敏敏 严金明 XU Yanzhong;ZHAO Haoyan;WANG Minmin;YAN Jinming(Radiology Department,Xuzhou City Hospital of TCM,Xuzhou 221000,China;Urology Surgery Department,Xuzhou City Hospital of TCM,Xuzhou 221000,China)
机构地区:[1]徐州市中医院放射科,江苏徐州221000 [2]徐州市中医院泌尿外科,江苏徐州221000
出 处:《临床医学研究与实践》2025年第10期102-105,共4页Clinical Research and Practice
摘 要:目的探讨CT相关参数对输尿管下段结石自行排出的预测价值。方法回顾性收集2019年1月至2023年6月在本院初诊为非复杂性输尿管下段结石的136例患者的CT平扫资料,根据临床保守治疗4周后CT复查结果将患者分为自行排出组和非自行排出组。采用单因素分析和多因素Logistic回归分析探究影响输尿管结石自行排出的因素,并以受试者操作特征(ROC)曲线评估其对输尿管下段结石自行排出的预测价值。结果136例输尿管下段结石患者中,自行排出组71例,非自行排出组65例。单因素分析结果显示,两组的结石横径、结石长径、结石体积、输尿管直径、输尿管结石直径比、结石床输尿管壁厚度及肾积水程度比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,结石长径、结石体积、输尿管结石直径比、结石床输尿管壁厚度是输尿管下段结石自行排出的独立预测因素(P<0.05)。ROC曲线分析结果显示,结石床输尿管壁厚度预测输尿管下段结石自行排出的曲线下面积(AUC)最大(0.891),截断值为3.25 mm,灵敏度为80.00%,特异度为85.90%。结论结石长径、结石体积、输尿管结石直径比、结石床输尿管壁厚度是输尿管下段结石自行排出的独立预测因素,其中结石床输尿管壁厚度为最佳预测指标。Objective To investigate the predictive value of CT parameters for spontaneous passage of lower ureteral calculi.Methods The CT plain scan data of 136 patients with uncomplicated lower ureteral calculi newly diagnosed in our hospital from January 2019 to June 2023 were retrospectively collected.According to the results of CT reexamination after 4 weeks of clinical conservative treatment,the patients were divided into spontaneous passage group and non-spontaneous passage group.The factors affecting the spontaneous passage of ureteral calculi were explored by single factor analysis and multivariate Logistic regression analysis,and the receiver operating characteristic(ROC)curve was used to evaluate its predictive value for the spontaneous passage of lower ureteral calculi.Results Among 136 patients with lower ureteral calculi,there were 71 cases in the spontaneous passage group and 65 cases in the non-spontaneous passage group.The results of single factor analysis showed that there were significant differences in the transverse diameter of calculi,the long diameter of calculi,the volume of calculi,the diameter of ureter,the ratio of ureter-to-stone diameter,the ureteral wall thickness of calculi bed and the degree of hydronephrosis between the two groups(P<0.05).Multivariate Logistic regression analysis results showed that the long diameter of calculi,the volume of calculi,the ratio of ureter-to-stone diameter,and the ureteral wall thickness of calculi bed were independent predictors of the spontaneous passage of the lower ureteral calculi(P<0.05).The results of ROC curve analysis results showed that the area under the curve(AUC)of the ureteral wall thickness of calculi bed to predict the spontaneous passage of lower ureteral calculi was the largest(0.891),the cut off value was 3.25 mm,the sensitivity was 80.00%,and the specificity was 85.90%.Conclusion The long diameter of calculi,the volume of calculi,the ratio of ureter-to-stone diameter and the ureteral wall thickness of calculi bed are independent predictors o
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