CAJ | 학술논문

目的探讨上段输尿管结石经体外冲击波碎石(ESWL)治疗前行静脉尿路造影(IVU)检查的价值.方法将腹部X线平片(KUB)证实为X线不透光的结石和超声检查无严重肾积水的单发上段输尿管结石100例患者随机分为两组,每组50例.IVU组ESWL前行IVU检查,对照组ESWL前不行IVU检查.观察ESWL治疗后并发症、结石清除率.结果 IVU组有7例退出研究.对照组和IVU组结石清除率分别为86.0%(43150)和83.7%(36/43);治疗成功率分别为94.0%(47/50)和95.3%(41/43);并发症发生率分别为26.0%(13/50)和27.9%(12/43),两组比较差异均无统计学意义(P＞0.05).结论 KUB证实为x线不透光的结石和超声检查无严重肾积水的单发上段输尿管结石患者,ESWL治疗前无需行IVU检查,这样可减少放射线暴露、避免造影剂的毒副作用并节省医疗费用.
목적 탐토상단수뇨관결석경체외충격파쇄석(ESWL)치료전행정맥뇨로조영(IVU)검사적개치.방법 장복부X선평편(KUB)증실위X선불투광적결석화초성검사무엄중신적수적단발상단수뇨관결석100례환자수궤분위량조,매조50례.IVU조ESWL전행IVU검사,대조조ESWL전불행IVU검사.관찰ESWL치료후병발증、결석청제솔.결과 IVU조유7례퇴출연구.대조조화IVU조결석청제솔분별위86.0%(43150)화83.7%(36/43);치료성공솔분별위94.0%(47/50)화95.3%(41/43);병발증발생솔분별위26.0%(13/50)화27.9%(12/43),량조비교차이균무통계학의의(P＞0.05).결론 KUB증실위x선불투광적결석화초성검사무엄중신적수적단발상단수뇨관결석환자,ESWL치료전무수행IVU검사,저양가감소방사선폭로、피면조영제적독부작용병절성의료비용.
Objective To study the impact of preprocedure intravenous urography (IVU) on the extracorporeal shock wave lithotripsy(ESWL) for proximal ureteral stones.Methods One hundred patients with solitary radiopaque proximal ureteral stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were allocated randomly to two treatment groups.IVU group (n=50) had IVU before the start of ESWL,whereas patients in control group (n=50) underwent ESWL without IVU.Postop- erative success,the stone-free rates and complications were evaluated in both groups. Results Seven patients in IVU group were excluded from the study. The success rate [95.3%(41/43) in IVU group vs 94.0% (47/50) in control group],stone-free rate [83.7% (36/43)vs 86.0% (43/50)] and complication rate[27.9% (12/43 ) vs 26.0% (13/50)]were similar in two groups (P＞0.05).Conclusions It is not necessary to obtain an IVU for patients who have solitary radiopaque proximal ureteral calculi on plain radiographs with no severe hydronephrosis on uhrasonographie examination before scheduling them for ESWL,thus minimizing the cost,avoiding exposure to contrast medium,and reducing radiation exposure.