基于术前多层螺旋CT测量的腰大肌指数对逆行输尿管软镜激光碎石手术难度的影响分析  

Influence of psoas major muscle index measured by preoperative multi-slice spiral CT on the difficulty of retrograde flexible ureteroscopic laser lithotripsy

作　　者：贺翔[1] 杨科[2] 陈贵恒 HE Xiang;YANG Ke;CHEN Gui-heng(Department of Emergency Surgery,Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University,Changsha Hunan 410102,China;Department of Urology,Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University,Changsha Hunan 410002,China)

机构地区：[1]湖南省人民医院/湖南师范大学附属第一医院急诊外科,湖南长沙410002 [2]湖南省人民医院/湖南师范大学附属第一医院泌尿外科,湖南长沙410002

出　　处：《局解手术学杂志》2023年第6期506-510,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：湖南省卫生健康委项目(C20180905);长沙市科技局项目(kq201495)。

摘　　要：目的分析基于术前多层螺旋CT测量的腰大肌指数对逆行输尿管软镜激光碎石手术难度的影响。方法对257例因输尿管上段结石接受逆行输尿管软镜激光碎石术的患者临床资料进行回顾性分析。采用多层螺旋CT测量L5椎骨水平的双侧腰大肌区域总面积,并与患者身高进行标准化得出腰大肌指数,记录总手术时间,使用线性回归分析研究手术时间的预测因素。结果腰大肌指数中位数为933.00 mm^(2)/m^(2)(IQR:711.00~1135.00 mm^(2)/m^(2)),手术时间中位数为50.00 min(IQR:40.00~65.00 min)。在多因素线性回归分析中,调整混杂因素之后,腰大肌指数、结石平均密度是手术时间的独立预测因素。结论腰大肌指数是一个易于测量的影像学参数,是影响逆行输尿管软镜激光碎石手术难度的独立预测因素,通过术前估算手术时间,有利于提高术者和手术室日程安排的效率。Objective To analyze the influence of psoas major muscle index measured by preoperative multi-slice spiral CT on the difficulty of retrograde flexible ureteroscopic laser lithotripsy.Methods The clinical data of 257 patients with upper ureteral calculi who underwent retrograde flexible ureteroscopic laser lithotripsy were analyzed retrospectively.Multi-slice spiral CT was used to measure the total area of bilateral psoas major muscle areas at L5 vertebral level,and the psoas major muscle index was obtained by standardized with patient's height.The total operation time was recorded and the linear regression analysis was used to study the predictive factors of operation time.Results The median psoas major muscle index was 933.00 mm^(2)/m^(2)(IQR:711.00 to 1135.00 mm^(2)/m^(2)),and the median operation time was 50.00 minutes(IQR:40.00 to 65.00 minutes).In multivariate linear regression analysis,the psoas major muscle index and the mean stone density were the independent predictors of operation time after adjusting for confounding factors.Conclusion The psoas major muscle index is an easy-to-measure imaging parameter and an independent predictor of the difficulty of retrograde flexible ureteroscopic laser lithotripsy.By estimating the operation time before operation,it is beneficial to improve the efficiency of the schedule of the operator and the operating room.

关 键 词：输尿管软镜 激光碎石术 腰大肌指数 多层螺旋CT 

分 类 号：R602[医药卫生—外科学]