超声引导下同轴导丝法更换肾盂造瘘管失败危险因素分析  

Risk factors of failure in replacement of pyelostomy tube with coaxial guide wire under ultrasound guidance

作　　者：孙园园 张智林 郑瑜[3] 巩雪 桑林 周惠惠 于铭 SUN Yuanyuan;ZHANG Zhilin;ZHENG Yu;GONG Xue;SANG Lin;ZHOU Huihui;YU Ming(Department of Ultrasound Medicine,Xijing Hospital,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学西京医院超声医学科,陕西西安710032 [2]南部战区总医院超声诊断科,广东广州510010 [3]西安市中心医院,陕西西安710004

出　　处：《陕西医学杂志》2023年第5期558-562,共5页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2021SF-260)。

摘　　要：目的:探讨长期留置肾盂造瘘管患者超声引导下同轴导丝法换管失败的危险因素。方法:回顾性分析超声引导下同轴导丝法更换肾盂造瘘管换管患者的临床资料,对比分析换管成功组与换管失败组的相关指标;采用多因素Logistic回归模型筛选影响超声引导下同轴导丝法换管失败的独立危险因素。结果:换管间隔时间、造瘘口周围皮肤感染及体重指数(BMI)在两组间比较具有统计学差异(P<0.05),多因素Logistic回归分析结果显示换管间隔时间≥90 d(OR=8.809,95%CI:2.270~34.188)、BMI≥24.0 kg/m^(2)(OR=5.091,95%CI:1.531~22.744)是导致换管失败的危险因素。结论:换管间隔时间≥90 d、BMI≥24.0 kg/m^(2)是导致同轴导丝法更换肾盂造瘘管失败的危险因素,对此类患者应慎用同轴导丝法换管。Objective:To investigate the risk factors of failure in replacement of pyelostomy tube with coaxial guide wire under ultrasound guidance.Methods:The clinical data of patients who underwent ultrasound guided coaxial guide wire replacement of pyelostomy tube were analyzed retrospectively.Multivariate Logistic regression analyses was used to screen the independent risk factors affecting the failure of ultrasonic guided coaxial guide wire tube replacement.Results:There were significant differences between the two groups in tube change interval,skin infection around the stoma and BMI.Multivariate Logistic regression analysis showed that tube change interval≥90 days(OR=8.809,95%CI:2.270 to 34.188),BMI≥24.0 kg/m^(2)(OR=5.091,95%CI:1.531 to 22.744)were independent risk factors for tube change failure.Conclusion:The interval between tube replacement≥90 days and BMI≥24.0 kg/m^(2) are the independent risk factors for failure in replacing renal pelvic fistula with coaxial guide wire method.The coaxial guide wire method shall be caution for such patients.

关 键 词：超声引导 肾盂造瘘 同轴导丝法 换管失败 体重指数 泌尿系感染 

分 类 号：R445.1[医药卫生—影像医学与核医学]