The Application Of CT Value In The Choice Of Treatment Methods For Ureteral Calculi

Objective : To study the value of Hounsfield unit(HU)on contrast-enhanced helical computerized tomography in prediction of the application value of extracorporeal shock wave lithotripsy(ESWL)and ureteroscopy lithotripsy(URL)in vivo ureteral calculi.At the same time,the composition of stone after ureteroscopy lithotripsy was analyzed by infrared spectrum,and to investigate the relationship between CT value and composition of calculi.Methods:A retrospective analysis was performed on 124 patients with ureteral calculi who met the inclusion criteria from September 2018 to September 2019.There were 56 cases in the ESWL group,with CT value ≤750HU as the experimental group,and >750HU as the control group,with 28 cases in each group.The success rate of first lithotripsy,success rate of multiple lithotripsy,stone residual rate and probability of postoperative complications in the two groups were analyzed and compared,and the CT value of stones in the first successful lithotripsy group was observed.There were 68 cases in the URL group,with CT value ≤900HU as the test group and >900HU as the control group,with 34 cases in each group.The lithotripsy efficiency and the incidence probability of postoperative complications in the two groups were analyzed and compared.Meanwhile,the composition analysis of postoperative stone samples was conducted to observe the relationship between lithotripsy efficiency and stone composition.Results: In the ESWL patients,it was found that the success rate of first lithotripsy and stone clearance rate of the test group with a CT value ≤750HU were both higher than the control group(P < 0.05),and the stone clearance rate was as high as 96.4%,with a significantly lower incidence of postoperative complications(P < 0.05).At the same time,the CT value of the stone group with first successful lithotripsy was statistically again,and it was found that the CT value was significantly lower than that of the other groups(P < 0.05).Among the patients in line URL,it was found that the test group with CT value ≤900HU had significantly higher lithotriptic efficiency and significantly lower incidence of postoperative complications than the control group(P < 0.05).After analyzing the composition of postoperative stone samples,it was found that the proportion of uric acid stones and magnesium ammonium phosphate stones was higher in the experimental group with higher lithotripsy efficiency,while the proportion of calcium oxalate stones was higher in the control group.Conclusion: It has practical value that CT value can guide the treatment of ureteral calculi.This study shows that the CT value of calculi can effectively guide clinical selection of safer,simpler and more effective treatment methods.Through the judgment of CT value of different components of calculi,it can guide the removal of stones,dissolution of stones and prevention of recurrence of ureteral stones more effectively.