输尿管软镜下钬激光碎石治疗输尿管上段结石并发输尿管狭窄的危险因素分析  

Analysis of risk factors for ureteral stricture in patients with upper ureteral calculi undergoing holmium laser lithotripsy under ureteral soft endoscopy

作　　者：刘建威[1] 谢青南[1] 张愚[1] LIU Jianwei;XIE Qinglan;ZHANG Yu(Department of Urology,Beijing You an Hospital Affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院泌尿外科,北京100069

出　　处：《中南医学科学杂志》2024年第2期292-294,共3页Medical Science Journal of Central South China

摘　　要：目的探讨输尿管软镜下钬激光碎石治疗输尿管上段结石并发输尿管狭窄的危险因素。方法选取输尿管上段结石患者988例,根据手术设备不同分为软镜组和硬镜组,比较两组皮质醇(Cor)、C反应蛋白(CRP)水平。软镜组根据术后有无并发输尿管狭窄分为狭窄组和非狭窄组,采用多因素Logistic回归分析输尿管狭窄的危险因素。结果两组术后Cor、CRP水平均高于术前,且软镜组低于同时间硬镜组(P<0.05)。软镜组输尿管狭窄发生率为5.60%。病程、结石直径、结石嵌顿和输尿管损伤是并发输尿管狭窄的独立危险因素(P<0.05)。结论输尿管软镜对该类患者机体应激反应影响更小,且病程、结石直径、结石嵌顿及输尿管损伤是并发输尿管狭窄的独立危险因素。Aim To explore the risk factors of upper ureteral stones complicated with ureteral stricture in patients treated with holmium laser lithotripsy under ureteroscopy.Methods 988 patients with upper ureteral stones were selected and divided into a soft mirror group and a hard mirror group based on different surgical equipment.The levels of cortisol(Cor)and C-reactive protein(CRP)were compared between the two groups.The soft endoscope group was divided into a stenosis group and a non-stenosis group based on the presence or absence of postoperative ureteral stricture.Multivariate Logistic regression analysis was used to identify the risk factors for ureteral stricture.Results The postoperative Cor and CRP levels in both groups were higher than those before surgery,and the soft mirror group was lower than the hard mirror group(P<0.05).The incidence of ureteral stricture in the soft endoscope group was 5.60%.The disease course,stone diameter,stone entrapment,and ureteral injury were independent risk factors for concurrent ureteral stricture(P<0.05).Conclusion Ureteroscopy has a smaller impact on the patient s stress response,and the disease course,stone diameter,stone entrapment,and ureteral injury are independent risk factors for ureteral stricture.

关 键 词：输尿管软镜 钬激光 输尿管上段结石 输尿管狭窄 危险因素 

分 类 号：R693[医药卫生—泌尿科学]