B超诊断输尿管结石价值.doc

B超诊断输尿管结石价值【摘要】 目的 评价B超在输尿管结石中的诊断价值。方法 对100例经手术取石、体外震波碎石和综合疗法排石证实为输尿管结石患者进行B超检查诊断分析。结果 本组100例输尿管结石患者中,B超诊断正确率为94.00%,无假阳性,漏诊6例,占6.00%。结论 B超诊断输尿管结石假阳性率低,可清晰显示X线阴性结石,有较高的临床应用价值和为临床及时准确地提供诊断和治疗依据,是急性肾绞痛的首选检查方法,特别是在基层医疗单位为首选检查方法。? 【关键词】 输尿管结石;B型超声;漏诊? ? Diagnostic value of B type ultrasound in ureteral calculi LI Cheng. Department of Ultrasound, Peoples Hospital of Deyang City, Sichuan, 618100 China 【Abstract】 Objective To evaluate the diagnostic value of B type ultrasound in ureteral calculi. Methods B type ultrasound examination were performed on 100 cases with ureteral calculi who were confirmed by open surgery,extracorporeal shock wave lithotripsy and comprehensive therapy. Results The diagnostic accuracy was 94.00% in 100 cases,no false positive was found,and the rate of missed diagnosis was 6.00%(6 cases). Conclusion B type ultrasound has a high application value in the diagnosis of ureteral calculi,which has low false positive rate and can clear display negative stone. It can also afford some accurate clues for diagnosis and clinical treatment in time according to abdomenal B type ultrasound and it will be preferred in way for diagnosis of acute nephrite colic especially in basic hospitals.? 【Key words】 Ureteral calculi; B type ultrasound;Missed diagnosis ? DOI:10.3760/cma.j.issn 1673-8799.2010.11.25? 作者单位:618000四川省德阳市人民医院超声科 ? 德阳市水质属于重水(水质偏硬),含有较多的钙、镁等离子,近年来,泌尿系统结石在我市发病率呈上升趋势。输尿管结石的诊断一度曾靠X线检查来诊断,其诊断率虽然很高,但对X线阴性结石及对造影剂过敏者诊断造成困难。近年来,随着B超诊断仪的迅猛发展及应用,为泌尿系统结石提供了一项简易、迅速、方便、无创伤的诊断检查手段,可清晰显示X线下不显影的低密度结石,在一定程度上弥补了X线检查存在的不足,有较高的临床应用价值。本文回顾分析我院经超声诊断且经临床证实的输尿管结石100例,报告如下,供参考。? 1 一般资料? 1.1 本组100例,男71例,女29例,年龄15～74岁,平均48岁。临床上患者以肾绞痛、下腹部疼痛和血尿为主,部分患者伴有发热、呕吐及会阴部放射痛。肉眼血尿者14例,镜下血尿者70例,无血尿者16例。病程数小时或数天,前来我科接受B超检查。? 1.2 设备采用GE RTFINO-4或MEDISON-6000ⅡC或SIEMENS-G20等B型黑白超声波诊断仪,探头频率3.5 MHz。? 1.3 检查方法 对急性肾绞痛患者无需进行肠道准备即刻行B超检查,非急性肾绞痛患者充盈膀胱后探查,部分患者受肠腔气体和肠道内容物影响图像时可进行清洁肠道后再行B超检查。探头方位可灵活,纵、横、斜、扇形扫查,掌握探头手力应均匀,必要时可适当加压。俯卧位探查时,首先找到肾脏和积水的肾盂,然后向下跟踪扩张的输尿管,