CAJ | 학술논문

目的：探讨大剂量静脉肾盂造影在输尿管阴性结石体外碎石中的应用效果。方法将86例输尿管阴性结石的患者按随机数字表法分为对照组和观察组，每组43例。对照组采用输尿管逆行插管造影定位联合体外冲击波碎石术（ESWL）治疗；观察组采用大剂量静脉肾盂造影定位联合ESWL治疗。对2组患者的排石情况及并发症（肾绞痛、血尿）发生率进行比较。结果2组患者在经一次碎石后2～20 d内均有不同程度的“细沙样”结石排出体外。2组患者一次治疗后结石的排净率比较差异无统计学意义（P＞0.05）。观察组和对照组分别有4例（9.30%）和5例（11.6%）体外排石失败改行腔内碎石术治疗；观察组发生并发症3例（肾绞痛2例、血尿1例，6.97%），对照组发生并发症4例（肾绞痛2例、血尿2例，9.30%），2组体外碎石失败率及并发症发生率的比较差异均无统计学意义（均P＞0.05）。结论大剂量静脉肾盂造影下行输尿管阴性结石ESWL治疗，结石排净率高、安全可靠，是治疗输尿管阴性结石的良好选择。
목적：탐토대제량정맥신우조영재수뇨관음성결석체외쇄석중적응용효과。방법장86례수뇨관음성결석적환자안수궤수자표법분위대조조화관찰조，매조43례。대조조채용수뇨관역행삽관조영정위연합체외충격파쇄석술（ESWL）치료；관찰조채용대제량정맥신우조영정위연합ESWL치료。대2조환자적배석정황급병발증（신교통、혈뇨）발생솔진행비교。결과2조환자재경일차쇄석후2～20 d내균유불동정도적“세사양”결석배출체외。2조환자일차치료후결석적배정솔비교차이무통계학의의（P＞0.05）。관찰조화대조조분별유4례（9.30%）화5례（11.6%）체외배석실패개행강내쇄석술치료；관찰조발생병발증3례（신교통2례、혈뇨1례，6.97%），대조조발생병발증4례（신교통2례、혈뇨2례，9.30%），2조체외쇄석실패솔급병발증발생솔적비교차이균무통계학의의（균P＞0.05）。결론대제량정맥신우조영하행수뇨관음성결석ESWL치료，결석배정솔고、안전가고，시치료수뇨관음성결석적량호선택。
Objective To evaluate the efficacy of high dose intravenous urography in extracorporeal shock wave lithotripsy (ESWL) for radioparent calculus in the ureter. Methods A total of 86 patients with ureteral radioparent calculus were randomly assigned to receive ESWL combined with either retrograde ureteral catheterization(control group, n=43) or high dose intravenous urography(observation group, n=43). The efficacies and complications(renal colic and hematuria) were compared between the two groups. Results Sand-like stones were excreted during 2-20 days after ESWL in both groups. There were no significant differences in the stone clearance rate between the two groups (P>0.05). Intracavitary lithotripsy was performed due to the failure of ESWL in 4 patients (9.30%) in control group and in 5 patients (11.6%) in observation group. The incidence of complications was 6.97% in observation group(renal colic in 2 and hematuria in 1) and 9.30%in control group(renal colic in 2 and hematuria in 2). There were no significant differences in failure rate of ESWL and incidence of complications between the two groups (P>0.05). Conclusion The combination of high dose intravenous urography and ESWL is a safe and reliable treatment with a high stone clearance rate for radioparent calculus in the ureter.