体外冲击波碎石单次治疗单发肾结石成功率的预测模型  

A model for predicting the success rate of a single extracorporeal shock wave lithotripsy session for single renal calculus

作　　者：张鹏[1] 吴芃[1] 杜跃军[1] 张辉见[1] 魏强[1] 侯祺[1] 古迪[1] 郑少斌[1] 刘成山[1] 

机构地区：[1]南方医科大学南方医院泌尿外科,广东广州510515

出　　处：《南方医科大学学报》2012年第6期894-896,900,共4页Journal of Southern Medical University

基　　金：广东省医学科研基金项目(WSTJJ2008111232012319780420951X);南方医院院长基金(2009C024)

摘　　要：目的探讨体外冲击波碎石（ESWL）治疗肾结石疗效的影响因素，并建立预测模型。方法2008年1月~2010年2月接受ESWL治疗的肾结石患者325例，最长随访3个月，用χ2检验或t检验进行单因素分析患者年龄、性别、体重指数、病程时间、治疗前肾绞痛、血尿、尿路刺激症状、结石位置、患侧、结石长径、宽径等因素与疗效的关系，筛选出有统计学意义的因素后，再利用Logistic逐步回归多因素分析并建立预测模型。结果ESWL治疗肾结石成功率76.9%（250/325）。单因素分析发现年龄、结石患侧、结石位置、病程时间、治疗前血尿、结石长、宽径对疗效均有影响。Logistic回归分析则显示病程时间、治疗前血尿、结石长、宽径决定治疗的成功率。预测模型拟合优度好（χ2=18.144，df=8，P=0.168），总体准确率为87.4%。结论病程时间、治疗前血尿、结石长、短径是ESWL单次治疗单发肾结石成功率的独立影响因素。Objective To evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy （ESWL） and establish a model for predicting the success rate of a single ESWL session in the treatment of single renal calculus. Methods Between January 2008 and February 2010, 325 patients underwent ESWL monotherapy and were followed up for at most 3 months. The correlations between the outcome of a single ESWL session and the patients＇ age, gender, body mass index （BMI）, disease duration, pretreatment renal colic, hematuria, urinary irritation symptoms, stone location, stone laterality, stone length and stone width were analyzed. The statistically significant factors identifies were further analyzed by multivariate logistic regression, and the predictive model was established. Results The stone-free rate of ESWL was 76.9%. Univariate analysis found that the patients＇ age, stone laterality, stone location, disease duration, pretreatment hematuria, stone length and width all significantly affected the outcome of the treatment. Logistic regression analysis indicated the factors including disease duration, pretreatment hematuria, stone length and stone width determined the success rate of the treatment. Hosmer and Lemeshow Test showed a good fitting of the predictive model （X2=18.144, df=8, P=0.168） with an overall accuracy of 87.4%. Conclusions Disease duration, pretreatment hematuria, stone length and width are independent factors affecting the outcome of a single ESWL session for single renal calculus.

关 键 词：体外冲击波碎石 肾结石 预测模型 LOGISTIC回归分析 

分 类 号：R699[医药卫生—泌尿科学]