以公式去更好地評估需要放置雙J導管輸尿管長度的方法

巫紹瑋、張宏江

國立台灣大學醫學院附設醫院 泌尿部

A Better Method to Estimate Ureter Length in Patient Who Needs DBJ Stenting by A Formula

Shao-Wei Wu, Hong-Chiang Chang

Department of Urology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Purpose: In clinical practice, we need to predict ureter length to choose the most suitable length of double J catheter. The most common method is to predict by body height. However, it is sometimes not accurate enough and the double J catheter may not be put in place. Our goal is to search for a better predictor for ureter length and a formula if available.

Method: In this particular study, we collected 100 cases of patient who underwent abdominal CT. We measured the ureter length by multiplying the number of slices between the level of the renal vein and the level of UVJ by the interval between slices(0.5cm) in the plane axial CT. A multivariate analysis evaluated the association between the ureteral length by axial CT and each of the following parameters: body height, L1 to L5 vertebral length on KUB and one vertebrae length plus one intervertebral disc length on KUB (we choose L4 vertebrae+L4-L5 disc length).

Result: The correlation of "height and ureter length" and "L1-L5 vertebrae distance and ureter length" are both significant (P value < 0.01), and L1-L5 vertebrae distance showed better correlation. The formulas calculated are "Right ureter(cm) = 0.767 x L1-L5 vertebrae(cm) + 8.684" and "Left ureter(cm) = 0.889 x L1-L5 vertebrae(cm) + 7.409".

Conclusion: The distance of L1-L5 vertebrae on KUB X-ray can more reliably predict the ureter length than body height. L1-L5 vertebrae length on KUB may probably be used as a parameter to predict ureter length for DBJ length selection.