CAJ | 학술논문

目的确定病人和结石在非增强螺旋CT上的特点,预言2种体外冲击波碎石后的结果:结石分散状态(游离状态)或体外碎石成功.方法回顾性分析200个相连续的用体外震波碎石治疗的肾结石患者.患者年龄、性别、结石侧别、体表面积、体重、结石最大容积、结石的平均CT值、结石密度、皮肤到结石距离,肾内结石的位置,研究这些潜在的预测因子.患者非肾脏、输尿管、膀胱手术后钙化,在第6周时拍腹部平片确定结石的分散状态,体外冲击波碎石成功者:结石残留碎片小于4mm.结果发现肾内结石的位置是唯一一个预测体外碎石后结石分散状态的因子.肾盂、肾盂输尿管交界处结石清除率要高于肾盏结石;上盏或中盏结石清除率要高于下盏.结石大小、平均CT值和结石的位置能够预测体外震波碎石的成功率.小结石和低CT值结石更容易被击碎,在肾盏结石中更高的离散状态和体外碎石的成功率发现与更短的皮肤-结石距离有关,肾盂结石和肾盂输尿管交界处结石排除在分析之外.结论结石的位置是体外震波碎石后获得结石离散状态最重要的因素,非增强螺旋结石特点:诸如结石大小、平均密度、结石肾内位置是体外震波碎石成功的重要预测因子.
목적 학정병인화결석재비증강라선CT상적특점,예언2충체외충격파쇄석후적결과:결석분산상태(유리상태)혹체외쇄석성공.방법 회고성분석200개상련속적용체외진파쇄석치료적신결석환자.환자년령、성별、결석측별、체표면적、체중、결석최대용적、결석적평균CT치、결석밀도、피부도결석거리,신내결석적위치,연구저사잠재적예측인자.환자비신장、수뇨관、방광수술후개화,재제6주시박복부평편학정결석적분산상태,체외충격파쇄석성공자:결석잔류쇄편소우4mm.결과 발현신내결석적위치시유일일개예측체외쇄석후결석분산상태적인자.신우、신우수뇨관교계처결석청제솔요고우신잔결석;상잔혹중잔결석청제솔요고우하잔.결석대소、평균CT치화결석적위치능구예측체외진파쇄석적성공솔.소결석화저CT치결석경용역피격쇄,재신잔결석중경고적리산상태화체외쇄석적성공솔발현여경단적피부-결석거리유관,신우결석화신우수뇨관교계처결석배제재분석지외.결론 결석적위치시체외진파쇄석후획득결석리산상태최중요적인소,비증강라선결석특점:제여결석대소、평균밀도、결석신내위치시체외진파쇄석성공적중요예측인자.
Objectives To determine the patient and noncontrast computed tomography (NCCT) stone characteristics that predict either of 2 extracorporeal shock wave lithotripsy (ESWL) outcomes: stone - free (SF)status or ESWL success. Methods The records of 200 consecutive patients with nephrolithiasis treated with ESWL were reviewed. Patient age, sex, stone laterality, body surface area, body mass index, maximal stone dimension,mean stone Hounsfield units (HU), stone Hounsfield density, skin- to- stone distance (SSD), and intrarenal stone location were studied as potential predictors. Patients with no calcifications on postoperative kidneys, ureters,and bladder (KUB) at 6 weeks were defined as SF. ESWL success was defined as SF or remaining stone fragments less than 4 mm. Results lntrarenal stone location was found to be the only predictor of SF status. Renal pelvic/ureteropelvic junction (UPJ) stones cleared better than calyceal stones, and upper/middle calyceal stones cleared better than lower calyceal stones. Stone size, mean HU, and location predicted ESWL fragmentation success. Smaller stones and stones with lower mean HU levels were more successfully fragmented. Higher SF and ESWL success rates were found with a shorter SSD among calyceal stones when renal pelvic/UPJ stones were excluded from analysis. Conclusions Stone location is the most important factor in achieving SF status after ESWL. NCCT stone characteristics such as stone size, mean HU, and intrarenal location are important predictors of ESWL success.