摘要
目的分析急诊输尿管结石的超声检查技巧与诊断价值。方法选择广东省佛山市南海区第六人民医院2018年1月至2020年1月急诊输尿管结石患者288例,所有患者均接受超声诊断,回顾其全部的临床资料,观察分析其诊断结果、声像图特征等。结果经超声检查,本组288例患者结石大小4mm×3mm~18mm×15mm,结石部位为上段102例(35.4%)、中段54例(18.8%)、下段132例(45.8%);双侧3例(1.2%)、右侧137例(47.5%)、左侧148例(51.3%)。其中28例合并肾周积液,占比9.7%;202例首次确诊,确诊率70.1%,84例复查≥2次后确诊,确诊率29.2%,未检出者2例,漏诊率0.7%,后经X线造影确诊。声像图特征:肾周围有液性暗区,呈月牙形或线条状,多处于肾下极,有程度不同的输尿管内强回声伴声影、输尿管扩张、肾集合系统分离等。其中口服排石21例、体外碎石267例,体外碎石主要治疗4mm以上者。结论急诊输尿管结石时采用超声的诊断价值较高,且检查时行多切面、多体位检查,可对于患者有无肾周积液予以及时发现,并对其变化予以动态观察,还可提升结石诊断准确性。
Objective To analyze examination skills and diagnostic value of ultrasonography in emergency ureteral calculi.Methods The paper chose 288 cases ureteral calculi patients in emergency department with ultrasound diagnosis from January 2018 to January 2020,reviewed clinical data,observed and analyzed diagnosis results and sonographic features.Results Ultrasonic examination showed,stone size of 288 cases was 4mm×3mm-18mm×15mm,location of 102 cases was upper segment(35.4%),that of 54 cases was middle segment(18.8%),that of 132 cases was lower segment(45.8%);3 cases were bilateral,(1.2%),137 cases right(47.5%),148 cases left(51.3%).Among them,28 cases were complicated with perirenal effusion,accounting for 9.7%;202 cases were diagnosed for the first time,with diagnosis rate of 70.1%.84 cases were diagnosed after reexamination more than twice,with diagnosis rate of 29.2%.2 cases were not detected,with missed diagnosis rate of 0.7%,and diagnosed by X ray radiography.Sonographic features:there are liquid dark areas around kidney,crescent shaped or linear,mostly in lower pole of the kidney,with varying degrees of strong echo in ureter with sound shadow,ureteral dilatation,separation of renal collecting system,etc.Among them,21 cases were treated with oral administration,267 cases above 4mm with extracorporeal lithotripsy.Conclusion Ultrasound has high value in diagnosis of emergency ureteral calculi,multi section and multi position examination can detect whether there is perirenal effusion timely,dynamically observation of it changes can improve diagnosis accuracy of ureteral calculi,which is worthy of further promotion and research.
作者
梁嘉明
LIANG Jia-ming(The Sixth People's Hospital of Nanhai District,Foshan City,Foshan,Guangdong,528000)
出处
《智慧健康》
2021年第21期8-10,共3页
Smart Healthcare
关键词
急诊
输尿管结石
超声
检查技巧
诊断价值
Emergency department
Ureteral calculi
Ultrasound
Inspection skills
Diagnostic value
