输尿管软镜钬激光碎石术后继发输尿管狭窄的相关性因素分析  

Correlation analysis of secondary ureteral stricture after flexible ureteroscopic holmium laser lithotripsy

作　　者：王淇超[1] 曹敬毅[1] 孙卫兵[2] 王乾[1] 宋墨 吴刚[1] 葛艳 Wang Qichao;Cao Jingyi;Sun Weibing;Wang Qian;Song Mo;Wu Gang;Ge Yan(Department of Urology,Xuzhou Hospital Affiliated to Jiangsu University,Tumor Hospital of Xuzhou City,Xuzhou 221005,China;Department of Urology,the Second Hospital Affiliated to Dalian Medical University,Dalian 116027,China)

机构地区：[1]江苏大学附属徐州医院,徐州市肿瘤医院泌尿外科,徐州221005 [2]大连医科大学附属第二医院泌尿外一科,大连116027

出　　处：《国际泌尿系统杂志》2022年第3期433-436,共4页International Journal of Urology and Nephrology

基　　金：徐州市科委资助课题(KC16SH038)。

摘　　要：目的探讨影响输尿管软镜钬激光碎石术治疗输尿管上段结石继发输尿管狭窄的相关因素。方法回顾性分析2011年1月至2020年6月于徐州市肿瘤医院行输尿管软镜下钬激光碎石术治疗的258例输尿管上段结石患者的临床资料,依据术后是否出现输尿管狭窄分为狭窄组(15例)及非狭窄组(243例)。分析两组患者的年龄、结石直径、是否合并糖尿病等临床资料的差异,运用logistic回归分析术后引发输尿管狭窄的相关因素。结果单因素分析显示:病程、结石直径、结石嵌顿、息肉包裹、输尿管损伤、手术时间与术后输尿管狭窄的发生均具有相关性(均P<0.05)。多因素logistic回归分析显示:病程、结石直径、结石嵌顿及输尿管损伤为术后发生输尿管狭窄的独立危险因素(均P<0.05)。结论病程长、结石较大、存在结石嵌顿及术中输尿管损伤的患者行输尿管软镜钬激光碎石术治疗时,术后易出现输尿管狭窄,因此术中应注意精细操作,术后注意严密随访。Objective To investigate the influence of soft ureteroscopic holmium laser lithotripsy in the treatment of ureteral stricture secondary to upper ureteral calculi.Methods The clinical data of 258 patients with upper ureteral calculi treated by holmium laser lithotripsy under soft ureteroscope in tumor hospital of Xuzhou city from January 2011 to June 2020 were retrospectively analyzed,and they were divided into stricture group(15 cases)and non-stricture group(243 cases)according to the occurrence of postoperative ureteral stricture.The differences in age,stone diameter,diabetes mellitus,stone incarceration and hydronephrosis between the two groups were analyzed,and the related factors of postoperative ureteral stricture were analyzed by logistic regression.Results Univariate analysis showed that the course of disease,stone diameter,stone incarceration,polyp encapsulation,ureteral injury,operation time were correlated with the occurrence of postoperative ureteral stricture(P<0.05).Multivariate logistic regression analysis showed that the course of disease,stone diameter,stone incarceration and ureteral injury were independent risk factors for postoperative ureteral stricture(P<0.05).Conclusions The patients with long duration of disease,larger diameter stone,stone incarceration and ureter injury were more likely to develop ureteral stricture after flexible ureteroscopic holmium laser lithotripsy,so full preoperative evaluations,improvement of surgical skill sand prevention as early as possible after operation should be considered.

关 键 词：输尿管结石 输尿管镜检查 碎石术 尿道狭窄 

分 类 号：R699.4[医药卫生—泌尿科学]