输尿管软镜碎石术治疗肾下盏体外冲击波碎石术后残余结石效果的影响因素分析  

Analysis of Influencing Factors of Effect of Flexible Ureteroscopic Lithotripsy in the Treatment of Residual Stones after Extracorporeal Shock Wave Lithotripsy of Lower Renal Calyx

作　　者：夏天成 徐国政 张帅 XIA Tiancheng;XU Guozheng;ZHANG Shuai(Wuxi No.8 People's Hospital,Wuxi 214142,China;不详)

机构地区：[1]无锡市第八人民医院,江苏无锡214142

出　　处：《中外医学研究》2025年第2期145-148,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析输尿管软镜碎石术(F-URS)治疗肾下盏体外冲击波碎石术(ESWL)后残余结石效果的影响因素。方法:选取2020年1月—2023年1月无锡市第八人民医院泌尿外科收治的98例肾下盏ESWL后残余结石患者作为研究对象,根据结石清除情况分为预后良好组(83例)与预后不良组(15例)。分析残余结石清除率(SFR)与影响因素的相关性,单因素及多因素分析残余结石清除效果的影响因素。结果:预后不良组结石直径>20 mm、结石密度高的例数多于预后良好组,结石体积、结石CT值、结石宽度、结石长度、结石形态学参数均高于预后良好组,差异有统计学意义(P<0.05);两组结石数量、术中出血量、术后住院时间、术中碎石成功率、结石内含物比率比较,差异无统计学意义(P>0.05)。结石直径、结石密度、结石体积、结石CT值、结石宽度、结石长度、结石形态学参数与结石清除效果呈负相关(P<0.05)。多因素logistic回归分析结果显示,结石直径、结石密度、结石体积、结石CT值、结石宽度、结石长度、结石形态学参数为残余结石清除效果的独立影响因素(P<0.05)。受试者工作特征(ROC)曲线显示,曲线下面积(AUC)为0.965(0.929,0.999),敏感度为0.866(0.775,0.932),特异度为0.937(0.681,0.998),差异有统计学意义(P<0.05)。结论:F-URS治疗肾下盏ESWL后残余结石患者,结石直径、结石密度、结石体积、结石CT值、结石宽度、结石长度、结石形态学参数与结石清除效果呈负相关,且这些因素亦是残余结石清除效果的独立影响因素。Objective:To analyze of the influencing factors of the effect of flexible ureteroscopic lithotripsy(F-URS)in the treatment of residual stones after extracorporeal shock wave lithotripsy(ESWL)of lower renal calyx.Method:A total of 98 patients with residual stones after ESWL of lower renal calyx who admitted to the Department of Urology in Wuxi No.8 People's Hospital were selected as the research objects,they were divided into the good prognosis group(83 cases)and the poor prognosis group(15 cases)according to the stone clearance.The correlation between residual stone free rates(SFR)and influencing factors were analyzed,and the influencing factors of residual stone clearance effect were analyzed by univariate and multivariate analysis.Result:The cases of stone diameter>20 mm number and high stone density in the poor prognosis group were more than those in the good prognosis group,the stone volume,stone CT value,stone width,stone length and stone morphological parameters were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05);there were no significant differences in the number of stones,intraoperative blood loss,postoperative hospital stay,intraoperative lithotripsy success rate and stone inclusion ratio between two groups(P>0.05).The stone diameter,stone density,stone volume,stone CT value,stone width,stone length and stone morphological parameters were negatively correlated with the stone clearance effect(P<0.05).Multivariate logistic regression analysis showed that stone diameter,stone density,stone volume,stone CT value,stone width,stone length and stone morphological parameters were independent influencing factors of residual stone removal effect(P<0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)was 0.965(0.929,0.999),the sensitivity was 0.866(0.775,0.932),and the specificity was 0.937(0.681,0.998),the difference was statistically significant(P<0.05).Conclusion:The stone diameter,stone density,stone volume,stone

关 键 词：输尿管软镜碎石术 肾下盏结石 体外碎石术 残余结石 

分 类 号：R699.2[医药卫生—泌尿科学]