摘要
目的 探讨上尿路泵功能指标对输尿管结石患者经保守治疗后排石情况的影响及预测价值。方法 选取88例结石直径为4~7 mm的单侧、单发输尿管结石患者。对所有患者进行肾脏排泄期动态容积CT扫描及上尿路泵功能指标检测,然后给予口服坦索罗新胶囊进行排石治疗。根据排石情况将患者分为排石组与未排石组,比较两组患者的上尿路泵功能指标。采用Logistic回归模型分析影响输尿管结石患者经保守治疗后排石情况的因素;采用受试者工作特征(ROC)曲线分析上尿路泵功能指标预测输尿管结石患者经保守治疗后排石情况的效能。结果 经4周保守治疗后,有54例(61.4%)患者排出结石(排石组),34例(38.6%)患者未排出结石(未排石组)。相比于未排石组,排石组结石侧的容积平均值、容积差、容积变化速度、容积变化速度最大值更低,肾盂完成一次收缩时间更短(均P<0.05)。排石组正常侧的容积平均值低于结石侧,而容积差、容积变化率、容积变化速度均大于结石侧(均P<0.05);未排石组正常侧的容积平均值、容积差、容积变化速度均低于结石侧,容积变化率大于结石侧(均P<0.05)。Logistic回归分析结果显示,容积差是输尿管结石患者经保守治疗后排石情况的独立影响因素(P<0.05)。ROC曲线分析结果显示,容积差预测输尿管结石患者经保守治疗后排石情况的曲线下面积为0.924,最佳临界值为0.43 mL,敏感度为0.875,特异度为0.733。结论 肾盂容积差是输尿管结石患者经保守治疗后排石情况的独立影响因素,肾盂容积差较小的输尿管结石患者,经保守治疗后更容易自行排出结石。
Objective To explore the effect and predictive value of upper urinary tract pump function indices on calculus discharge in patients with ureteral calculus after conservative treatment.Methods A total of 88 patients suffering from unilateral or single ureteral calculus with calculus diameter from 4 mm to 7 mm were selected,and they underwent dynamic volume CT scanning in renal excretion stage and the detection of upper urinary tract pump function indices,after that they received oral administration of Tamsulosin Capsule for treatment of calculus discharge.The patients were assigned to the calculus discharge group or the calculus non-discharge group according to the condition of calculus discharge.The upper urinary tract pump function indices were compared between the two groups.The Logistic regression model was employed to analyze the factors affecting calculus discharge in patients with ureteral calculus after conservative treatment.The receiver operating characteristic(ROC) curve was used to analyze the efficiency of upper urinary tract pump function indices in predicting the efficiency on calculus discharge in patients with ureteral calculus after conservative treatment.Results After 4 weeks of conservative treatment,calculus in 54(61.4%) patients were discharged(the calculus discharge group),and in 34(38.6%) patients were not discharged(the calculus non-discharge group).Compared with the calculus non-discharge group,the calculus discharge group exhibited a lower mean volume value,volume difference,volume change velocity,and maximum volume change velocity of calculus side,as well as shorter time to complete one contraction of renal pelvis(all P<0.05).The calculus discharge group depicted a lower mean volume value of normal side,whereas larger volume difference,volume change rate,and volume change velocity of normal side as compared with of calculus side(all P<0.05).The calculus non-discharge group interpreted lower mean volume value,volume difference,volume change velocity of normal side,while a larger volume change rate of normal side as compared with of calculus side(all P<0.05).The results of Logistic regression analysis revealed that volume difference was an independent influencing factor for calculus discharge in patients with ureteral calculus after conservative treatment(P<0.05).The results of ROC curve analysis showed that the area under the curve of volume difference in predicting calculus discharge in patients with ureteral calculus after conservative treatment was 0.924,the optimal critical value was 0.43 mL,the sensitivity was 0.875,and the specificity was 0.733.Conclusion Volume difference of renal pelvis is an independent influencing factor for calculus discharge in patients with ureteral calculus after conservative treatment.The patients with smaller renal pelvic volume difference are more likely to discharge calculus by themselves after conservative treatment.
作者
李松
苏云杉
仓宇
毛崇文
LI Song;SU Yun-shan;CANG Yu;MAO Chong-wen(Department of Urology Surgery,the Affiliated Hospital of Yunnan University,Kunming 650021,Yunnan,China;Department of Radiology,the Affiliated Hospital of Yunnan University,Kunming 650021,Yunnan,China)
出处
《广西医学》
CAS
2022年第18期2104-2108,共5页
Guangxi Medical Journal
基金
云南省科技计划项目[2017FE467(-197)]。
关键词
输尿管结石
保守治疗
排石
上尿路泵功能
预测价值
Ureteral calculus
Conservative treatment
Calculus discharge
Upper urinary tract pump function
Predictive value
