糖尿病对输尿管结石患者自发排石的影响  

The effect of diabetes mellitus on the spontaneous passage of ureteral stones

作　　者：曾凯[1] 李应龙[1] 钱彪[1] 倪钊[1] 王新敏[1] 李强[1] 王文晓[1] 王勤章[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院泌尿外科,新疆石河子832008

出　　处：《现代泌尿外科杂志》2016年第5期338-341,共4页Journal of Modern Urology

基　　金：国家科技支撑计划子课题(No.2013BAI05B05);新疆生产建设兵团医药卫生重点项目科技援疆专项(No.2014AB052)

摘　　要：目的探讨糖尿病对输尿管结石自行排出的影响。方法回顾性收集2013年1～8月间因在我院行保守排石治疗的255例输尿管结石患者的临床资料。根据患者是否合并糖尿病分为糖尿病组和非糖尿病组。保守排石治疗4周后复查泌尿系超声或CT判断结石是否排出。采用单因素分析法及Logistic回归模型分析糖尿病是否是影响结石排出的危险因素,并结合结石大小及位置分析糖尿病对输尿管结石自行排出的影响。结果 255例患者中147例结石自行排出,排石率为57.65%;45例合并有糖尿病的患者中有16例结石自行排出,排石率为35.56%。Logistic回归结果显示结石大小、位置及是否患有糖尿病是影响结石排出的独立危险因素。糖尿病对横径在0.8～1.0cm及上段和下段输尿管结石的排出率有显著影响（P〈0.05）。结论糖尿病是影响结石排出的独立危险因素。对于结石横径较大且合并有糖尿病的患者,建议直接行体外冲击波碎石或输尿管镜碎石术。Objective To analyze the effect of diabetes on the spontaneous passage of uretaral calculi.Methods The clinical date of 255 patients with ureteral calculi treated during Jan.and Aug.2013 in our hospital were retrospectively reviewed.The patients were divided into diabetic group and non-diabetic group according to whether they were complicated with diabetes.Four weeks after conservative treatment,ureteral ultrasound or CT was used to determine whether stones were discharged.The single factor analysis and Logistic regression analysis were adopted to screen the influencing factors and analyze the effect of diabetes on the spontaneous passage of uretaral calculi.Results Among the 255 patients,147 self-discharged ureteral calculi,and the stone passage rate was 57.65%.Of the 45 diabetic patients,16 self-discharged ureteral calculi,and the stone passage rate was 35.26%.Logistic regression analysis showed that stone size,location and diabetes were factors influencing the spontaneous passage of ureteral calculi.Diabetes had a significant effect on the stone passage rate when the stone diameter was 0.8-1cm and the stones were located on the upper and lower ureter（P〈0.05）.Conclusion Diabetes is an independent risk factor for the spontaneous passage of uretaral calculi.Patients with large ureteral calculi and diabetes should be given shock wave lithotripsy or ureteroscopy.

关 键 词：糖尿病 输尿管结石 药物排石治疗 

分 类 号：R693.4[医药卫生—泌尿科学]