目的:探討雙豬尾型輸尿管內支架(Double pigtail stent,DPS)作為泌尿外科上尿路疾病手術輔助治療的適應癥、并發癥及并發癥的治療。方法:總結我院2004年6月至2008年12月共122例施行輸尿管內支架放置術患者的適應癥、并發癥及并發癥的治療結果。結果:24例患者(19.6%)在置管期間出現1個或以上并發癥。主要并發癥包括肉眼血尿(9例)、疼痛(16例)、膀胱刺激征(12例)、高熱(1例)。大部分并發癥是輕微和可以耐受的,并迅速得到了適當的處理。2例須拔除內支架,其中劇烈疼痛1例、高熱1例。結論:DPS用于上尿路疾病手術輔助治療是安全和有效的,DPS引起的并發癥大部分易于處理。
Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.