CT值联合熵值对输尿管上段结石行体外冲击波治疗的预测价值

doi:10.3969/j.issn.1005-6483.2019.11.013

摘要/Abstract

摘要： 目的：探讨CT值联合熵值预测体外冲击波碎石术（ESWL）治疗输尿管上段结石疗效的应用价值。方法：收集2017年10月～2018年6月于我院行非增强多层螺旋CT（MDCT）检查和ESWL的输尿管上段结石的病人共83例，根据治疗后4周结石清除效果分为成功组（52例）和失败组（31例）。比较两组病人的性别、年龄和结石直径以及结石CT值和熵值，分析结石CT值联合熵值对病人 ESWL 治疗效果的预测价值。结果：31例（37%）病人碎石失败。两组的病人的基本资料如性别，年龄和结石直径比较差异无统计学意义（P>0.05）。成功组的CT值为（691.73±171.34）HU，失败组为（852.74±180.98）HU，成功组的熵值为4.25±0.57，失败组为4.81±0.41，两组比较差异均有统计学意义（P＜0.05）。根据CT值（750HU）和熵值（4.5）将病人分为4个危险类别，CT值>750HU和熵值>4.5（10/29），CT值≤750HU和熵值>4.5（7/13），CT值>750HU和熵值≤4.5（11/14），CT值≤750HU和熵值≤4.5（24/27），其相关的ESWL清石率分别为34.5%，53.8%，78.6%，88.9%。结论：结石CT值联合熵值可较好地预测输尿管上段结石病人ESWL的治疗效果，CT值和熵值越低，ESWL治疗后结石清除率越高。

关键词: 体外冲击波碎石术, 输尿管上段结石, CT值, 熵值

Abstract: Objective：To investigate whether CT value combined with entropy can predict the efficacy of extracorporeal shock wave lithotripsy（ESWL）in the treatment of upper ureteral calculi.Methods：A total of 83 patients with upper ureteral calculi who underwent unenhanced multislice spiral CT（MDCT）and extracorporeal shock wave lithotripsy from October 2017 to June 2018 were collected.According to the stone removal effect 4 weeks after treatment，the patients were divided into successful group（n=52）and failure group（n=31）.The success of ESWL was defined as the absence of residual stone fragments or residual stone fragments no larger than 2mm after 4 weeks of single lithotripsy.The basic data of the two groups，such as sex，age and stone diameter，were analyzed and compared.At the same time，the CT value and entropy of stones in the two groups were statistically compared，and the predictive value of stone CT combined with entropy to the therapeutic effect of ESWL was analyzed.Results：31 patients（37%）failed in lithotripsy.There was no significant difference in basic data such as sex，age and stone diameter between the two groups（P>0.05）.The CT value of success group was（691.73±171.34）HU，and that of failure group was（852.74±180.98）HU.There was significant difference between the two groups.The entropy value of success group was（4.25±0.57），and that of failure group was（4.81±0.41）.There was significant difference between the two groups（P<0.05）.According to the CT value and entropy value，the patients were divided into four risk categories：Ct value >750HU and entropy value >4.5（10/29），Ct value ≤750HU and entropy value >4.5（7/13），Ct value >750HU and entropy value ≤4.5（11/14），Ct value ≤750HU and entropy value≤4.5（24/27），the related ESWL stone removal rates were 34.5%，53.8%，78.6% and 88.9%，respectively.Conclusion：The CT value combined with entropy can predict the therapeutic effect of ESWL in patients with upper ureteral calculi.The lower the CT value and entropy value，the higher the stone clearance rate after ESWL treatment.

Key words: extracorporeal shock wave lithotripsy, proximal ureteral stone, CT value, entropy

张园, 潘敏, 汪翔, 李聪, 杨帆. CT值联合熵值对输尿管上段结石行体外冲击波治疗的预测价值[J]. 临床外科杂志, 2019, 27(11): 965-967.

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