体外冲击波治疗输尿管上段结石成功率的预测因素分析

A retrospective analysis for predicting extracorporeal shock-wave lithotripsy in treating proximal ureteral stone

摘要:

目的：探索单次体外冲击波碎石术治疗输尿管上段结石成功率的预测因素。方法：回顾性分析了符合纳入标准的79例体外碎石术前接受多层螺旋CT平扫（multi-detector computed tomography，MDCT）的患者，男性61例，女性18例；平均年龄43.5岁。评估性别、年龄、结石位置、体质指数（body mass index，BMI）、结石体表距离（skin-to-stone distance，SSD）、结石长径、结石最大横径、体积以及密度值（Hounsfield unit，HU）与体外冲击波碎石成功率的关系。结果：单因素分析提示，结石长径（P=0.038），结石最大横径（P=0.001）和结石密度值（P=0.001）的差异有统计学意义。多因素回归分析提示，结石最大横径（RR=7.953，P=0.003）和结石密度值（RR=3.31，P=0.048）是影响碎石失败率的危险因素。结论：结石密度值是影响体外碎石成功率的重要影响因素；除此之外，结石横径而非直径也是体外碎石成功率的显著影响因素。

Abstract:

Objective：To evaluate the possible predictors of proximal ureteral stone disintegration by shock wave lithotripsy（SWL）. Methods：This retrospective study included 79 patients（61 males，18 females； mean age：43.5 years） who were performed non-en－hanced multi-detector computed tomography（MDCT） before SWL. The possible predictors such as gender，age，stone location，stone length，stone cross-sectional diameter，stone volume，body mass index（BMI），skin-to-stone distance（SSD），and stone density （Hounsfield unit，HU） were analyzed. Results：The stone length（P=0.038），cross-sectional diameter（P=0.001） and stone density（P=0.001） were significant different based on univariate analysis. By the multiple liner regression analysis，the stone density（RR=3.31，P=0.048） and cross-sectional diameter（RR=7.953，P=0.003） were considered to be the independent predictors of SWL success. Conclusion：Instead of stone length，the cross-sectional diameter and stone density were the independent predictors of SWL success.