【摘要】 目的研究螺旋CT值对186例输尿管结石采用钬激光碎石的预测价值。方法 186例输尿管结石患者,术前进行结石的螺旋CT值测定,根据测定结果对结石成分进行预测。所有患者行钬激光输尿管镜或经皮肾镜碎石取石术,观察碎石效果。结果不同成分结石的CT值根据大小排列如下:二水磷酸氢钙结石为8例, CT值(1496±47)HU;碳酸磷灰石为31例, CT值(1246±132)HU;一水草酸钙结石为76例, CT值(637±116)HU;二水草酸钙结石58例, CT值(615±35)HU;尿酸结石为13例,CT值(327±38)HU。钬激光对大多数输尿管结石均具有良好的效果,但是输尿管结石内含有基质成分时,碎石效果差,采用钳夹的方式较好。结论通过术前螺旋CT值的测定,采用钬激光碎石,能够对手术时间和碎石效率进行评估,适用于大多数输尿管结石腔内碎石,能取得较好的临床效果。螺旋CT值的测定对采用钬激光输尿管结石碎石具有较好的临床预测价值。更多还原

【Abstract】 Objective To study the value of spiral CT in predicting 186 cases of ureteral calculi treated with holmium laser lithotripsy. Methods In 186 patients with ureteral calculi, the spiral CT values of the calculi were measured before the operation, and the composition of the calculi was predicted based on the measurement results. All patients underwent holmium laser ureteroscopic lithotripsy, and the the lithotripsy effect was observed. Results The CT values of calculi with different components were arranged according to the numerical range as follows: 8 cases of calcium hydrogen phosphate dihydrate, CT value(1496±47) HU; 31 cases of carbonate apatite, CT value(1246±132) HU; 76 cases of calcium oxalate monohydrate, CT value(637±116) HU; 58 cases of calcium oxalate dihydrate calculi, CT value(615±35) HU; 13 cases of uric acid calculi, CT value(327±38) HU. Holmium laser has a good effect on most ureteral calculi, but when the ureteral calculi contain matrix components, the lithotripsy effect is poor, and the clamp method is better. Conclusion Through the measurement of preoperative spiral CT value, holmium laser lithotripsy can evaluate the operation time and lithotripsy efficiency. It is suitable for most intracavitary lithotripsy of ureteral stones and can achieve better clinical results. The measurement of spiral CT value has a good clinical predictive value for the use of holmium laser ureteral calculi lithotripsy.更多还原