双J管管壁结石形成影响因素的横断面研究  

The Cross-sectional Study on the Influence Factors for Encrustation of Double J Stent in Patients with Urolithiasis

作　　者：曹祥明 刘嘉铭[1] 廖邦华[1] 朱池海 李虹[1] 罗德毅[1] 王建忠[1] 王坤杰[1] 

机构地区：[1]四川大学华西医院泌尿外科,成都610041

出　　处：《四川大学学报（医学版）》2015年第3期431-435,共5页Journal of Sichuan University(Medical Sciences)

基　　金：教育部博士点基金(No.20110181130003);四川大学交叉学科研究项目(No.2010SCU22002);成都市科技攻关项目(No.10GGYB749SW-023);四川省科技厅科技支撑计划项目(No.2014SZ0028)资助

摘　　要：目的了解双J管管壁结石形成的基本情况,探讨分析双J管管壁结石形成的影响因素。方法纳入2014年2～7月在我科因上尿路结石接受输尿管软镜联合钬激光碎石术的患者共84例,收集相关临床资料,使用电脑体式显微镜观测双J管管壁结石形成情况,对临床资料与管壁结石形成之间的关系采用t检验、χ2检验、Fisher确切概率法、logistic回归进行统计学分析。结果双J管平均留置时间（17.0±6.0）d,67例（79.8%）双J管形成管壁石膜。石膜形成组较未形成石膜组更年轻〔（44.9±11.5）岁vs.（54.4±12.6）岁,P=0.004〕;尿蛋白阳性患者的管壁石膜形成率更高〔62/73（84.9%）vs.5/11（45.5%）,P=0.002〕;尿路感染阳性者较阴性者石膜形成率高〔26/28（92.9%）vs.41/56（73.2%）,P=0.035〕;血尿阳性者较阴性者石膜形成率高〔67/80（83.8%）vs.0/4,P=0.001〕。不同性别、双J管留置时间、血清钙、无机磷、尿酸、尿pH、结石类型之间石膜形成率差异无统计学意义（P〉0.05）。取5例双J管管壁结石进行结石成分分析,发现与原发结石成分完全一致。Logistic回归发现石膜形成与低龄和尿蛋白相关（P〈0.05）,与血尿和尿路感染无关（P〉0.05）。结论影响管壁石垢形成的因素众多,尿蛋白阳性和低龄是双J管表面结石形成的重要危险因素。Objective To study the influence factors for encrustation of double J stent in patients with urolithiasis.Methods In this study,there were 84 urolithiasis patients with double J stent included from February to July 2014 in our hospital.The encrustation on double J stent was evaluated by a PC stereo microscope.The interrelated clinical data were obtained,then the factors which may affect the encrustation were studied by logistic regression analysis.Results The mean indwelling time was（17.0±6.0）d,and a thin encrustation formed on the stents for most cases 〔67/84（79.8%）〕.Compared with the cases who did not form a thin encrustation,those having a thin encrustation formation on the stent were younger〔（44.9±11.5）vs.（54.4±12.6）,P=0.004〕.The patients with proteinuria got a higher rate of encrustation 〔62/73（84.9%）vs.5/11（45.5%）,P=0.002〕.The patients with urinary tract infection had a higher rate of encrustation 〔26/28（92.9%）vs.41/56（73.2%）,P=0.035〕.The patients with hematuriaalso got a higher rate of encrustation 〔67/80（83.8%）vs.0/4,P=0.001〕.Different sex,retention time,serum calcium,inorganic phosphorus,uric acid,urine pH,lithiasis component had no effects on encrustation（P〉0.05）.Logistic regression analysis showed that age and proteinuria was retained as independent correlated factors with encrustation（P〈0.05）,while hematuria and urinary tract infections had a low intensity correlation with encrustation（P〉0.05）.Conclusion For encrustation of double J stentin patients with urolithiasis,younger age,increased urinary protein,hematuria and infections are important risk factors.

关 键 词：双J管 管壁结石 影响因素 

分 类 号：R699[医药卫生—泌尿科学]