CT尿路造影在非肾小球血尿诊断中的价值

发布时间：2018-06-21 12:54

本文选题：CT造影 + 血尿　；参考：《大连医科大学》2012年硕士论文

【摘要】：目的：探讨多层螺旋CT尿路造影(Multi-slice spiral CT urography，，MSCTU)在非肾小球血尿诊断中的价值。材料和方法：前瞻性分析我院2009年10月～2012年2月血尿患者,依据实验设计的血尿诊断流程对所有患者行病史采集、体格检查、尿液检查、泌尿系统超声检查及MSCTU检查,根据超声检查及MSCTU结果进一步行其他检查如膀胱镜检查、输尿管镜及病理检查等明确血尿原因。评估CTU在肾癌、上尿路肿瘤、结石等患者在超声和膀胱镜检查后作为补充手段的应用价值。用单因素及多因素统计方法分析影响CTU阳性结果的相关因素。结果：共收集112例病人，其中31例血尿病人没有检测到明确病因，43例血尿患者为良性病变，38例血尿患者为恶性病变。112例血尿患者行横断面扫描有81例发现了上尿路系统的病变。超声结果（OR值6.224，95%CI:1.094-10.536，P=0.001）和血尿的类型（OR值4.047，95%CI:1.693-9.669，P=0.02)是CTU阳性结果的重要指标。37例患者超声检查没有发现异常，其中有12例CTU发现存在病变。28例镜下血尿患者经CTU检查并没有发现上尿路病变的损害，而18例镜下血尿的患者经CTU检查发现了上尿路疾病。结论：对于镜下血尿患者，超声检查可以排除明显的上尿路疾病。对于肉眼血尿的患者，发生上尿路疾病的可能性很高，CTU可作为首选的检查方式。
[Abstract]:Objective: to evaluate the value of multi-slice spiral CT urography MSCTU in the diagnosis of non-glomerular hematuria. Materials and methods: patients with hematuria in our hospital from October 2009 to February 2012 were prospectively analyzed. History collection, physical examination, urine examination, ultrasound examination of urinary system and MSCTU examination were performed on all patients according to the procedure of hematuria diagnosis designed by the experiment. Other examinations such as cystoscopy, ureteroscopy and pathology were performed according to the results of ultrasonography and MSCTU to determine the causes of hematuria. To evaluate the application value of CTU in renal carcinoma, upper urinary tract tumor, stone and other patients after ultrasonography and cystoscopy. Univariate and multivariate statistical methods were used to analyze the related factors affecting CTU positive results. Results: a total of 112 cases of hematuria were collected. Among them, 31 cases of hematuria had no definite etiology. 43 cases of hematuria were benign lesions. 38 cases of hematuria patients were malignant lesions .112 cases of hematuria patients underwent cross-sectional scanning 81 cases found the lesions of upper urinary tract system. The OR value was 6.22495% (CI: 1.094-10.536P0. 001) and the type of blood and urine (OR = 4.047 ~ 95CI: 1.693-9.669P0.02) was an important index of CTU positive results. There was no abnormality in ultrasound examination in 37 patients. There were 12 patients with CTU and 28 patients with hematuria under the microscope. The lesions of the upper urinary tract were not found by CTU examination, but the diseases of the upper urinary tract were found by CTU examination in 18 patients with hematuria under the microscope. Conclusion: for patients with hematuria under microscope, ultrasound examination can exclude obvious upper urinary tract diseases. For patients with naked hematuria, the risk of upper urinary tract disease is high.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.7

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