影响输尿管软镜碎石手术一期结石清除率及安全性的临床因素研究  

Analysis of clinical factors affecting the one-time stone free rate and safety of flexible ureteroscopic lithotripsy

作　　者：李柳林 张扬[1] 马隆[1] 丛小明[1] 陈雪花[1] 邓仲磊[1] 徐彦[1] Li Liulin;Zhang Yang;Ma Long;Cong Xiaoming;Chen Xuehua;Deng Zhonglei;Xu Yan(Department of Urology,Traditional Chinese Medicine Hospital of Jiangsu Province(Affiliated Hospital of Nanjing University of Traditional Chinese Medicine),Nanjing 210029,China)

机构地区：[1]江苏省中医院(南京中医药大学附属医院)泌尿外科,南京210029

出　　处：《国际泌尿系统杂志》2024年第2期211-215,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨影响输尿管软镜碎石手术一期结石清除率及安全性的临床因素。方法回顾性分析2015年10月至2020年12月于本院泌尿外科微创中心一期行输尿管软镜碎石手术的713例患者的临床资料,排除复杂性特殊结石患者,如髓质海绵肾、马蹄肾结石、肾盏憩室内结石等,最终纳入658例患者。统计分析患者的术后一期结石清除率与临床并发症(安全性)情况,采用单因素和多因素logistic回归分析输尿管软镜碎石术(FURL)后一期结石清除率(SFR)及安全性的影响因素。结果658例患者FURL术一期的SFR为79.9%(526/658),并发症发生率为5.62%(37/658)。单因素及多因素logistic回归分析结果显示:结石最大累计长径、结石CT值和手术时间与FURL术后一期SFR有相关性(均P<0.05);手术时间、结石累计长径与手术并发症有相关性(P<0.05)。结论临床上通过对输尿管软镜碎石结石中影响清除率及安全性的有临床意义的指标进行术前评估,可以合理地预测术后SFR及并发症,从而指导医生选择合适的术式,增加手术的安全性和有效性。Objective To investigate the clinical factors affecting the one-time stone free rate and safety of flexible ureteroscopic lithotripsy.Methods The clinical data of 713 patients who underwent flexible ureteroscopic lithotripsy in the minimally invasive center of our urology department from October 2015 to December 2020 were retrospectively analyzed,and patients with complex and special stones such as medullary sponge kidney,horseshoe kidney stones,calyceal diverticulum stones,etc were excluded,and finally including 658 patients.Statistical analysis of postoperative one-time stone free rate and clinical complications(safety)of patients.Univariate and multivariate logistic regression were used to analyze the factors affecting the first-stage stone free rate(SFR)clearance and safety after ureteral soft lithotripsy.Results The SFR of 658 patients at the first stage of FURL operation was 79.9%(526/658),and the complication rate was 5.62%(37/658).The maximum cumulative stone diameter,stone CT value and operation time were closely related to the one-time stone free rate after flexible ureteroscopic lithotripsy(all P<0.05).Complications were closely related with operation time(P<0.05).Conclusions In clinical practice,preoperative evaluation of clinically significant factors influencing the postoperative SFR and safety before flexible ureteroscopic lithotripsy can reasonably predict postoperative SFR and complication,so as to select appropriate surgical methods and increase the possibility of surgical safety and efficacy.

关 键 词：肾结石 输尿管镜检查 结石清除率 

分 类 号：R699.4[医药卫生—泌尿科学]