摘要
目的分析输尿管嵌顿性结石形成的影响因素并观察微创经皮肾镜技术(MPCNL)的结石清除率。方法分析2017年2月—2020年2月解放军联勤保障部队第九〇四医院泌尿外科收治的126例输尿管结石患者的临床资料。所有患者均行MPCNL治疗,根据输尿管结石嵌顿情况分为非嵌顿组(n=74)和嵌顿组(n=52),分析影响输尿管嵌顿性结石形成的因素,同时观察两组术后结石清除率。结果单因素分析显示,两组既往同侧结石病史、合并高血压、合并肾盂积水、结石体积、结石横径、结石最大横截面积、结石CT值、输尿管壁最大厚度(UWTmax)比较,差异均有统计学意义(均P<0.05)。多因素分析显示,UWTmax是形成输尿管嵌顿性结石的独立危险因素(OR=3.080,95%CI:1.056~8.981,P<0.05)。UWTmax诊断输尿管嵌顿性结石的最佳临界值为3.41 mm,曲线下面积为0.871(95%CI:0.786~0.955),特异性为87.65%,敏感度为82.63%。非嵌顿组MPCNL结石清除率高于嵌顿组,差异有统计学意义(P<0.05)。结论UWTmax是形成输尿管嵌顿性结石的独立危险因素,UWTmax≥3.41 mm时,输尿管结石嵌顿的发生风险增加,MPCNL治疗输尿管嵌顿性结石的结石清除率稍低。
Objective To analyze the influencing factors of the formation of incarcerated ureteral stones and observe the stone removal rate of minimally invasive percutaneous nephrolithotomy(MPCNL).Methods Clinical data of 126 patients with ureteral stones admitted to the Department of Urology,the 904th Hospital of the PLA Joint Logistic Support Force from February 2017 to February 2020 were analyzed.All patients were performed MPCNL treatment,according to the incarceration of ureter stones,they were divided into non-incarcerated group(74 cases)and incarcerated group(52 cases).The factors affecting the formation of incarcerated ureteral stones were analyzed,and the stone removal rate of two groups were observed.Results Univariate analysis showed that there were statistically significant differences between two groups in the history of ipsilateral stones,combined hypertension,combined hydronephrosis,stone volume,stone transverse diameter,stone maximum cross-sectional area,stone CT value and maximum thickness of ureteral wall(UWTmax)(all P<0.05).Multivariate analysis showed that UWTmax was an independent risk factor for the formation of incarcerated ureteral stones(OR=3.080,95%CI:1.056-8.981,P<0.05).The optimal cut-off value of UWTmax was 3.41 mm,the area under the curve was 0.871(95%CI:0.786-0.955),the specificity was 87.65%,and the sensitivity was 82.63%.The MPCNL stone removal rate of non-incarcerated group was higher than that of incarcerated group,and the difference was statistically significant(P<0.05).Conclusion UWTmax is an independent risk factor for the formation of incarcerated ureteral stones.UWTmax≥3.41 mm increases the risk of incarcerated ureteral stones,and the stone removal rate after treatment with MPCNL for incarcerated ureteral stones is slightly lower.
作者
丁俊
刘俊强
张超
李国波
朱旭明
孙建鸣
DING Jun;LIU Junqiang;ZHANG Chao;LI Guobo;ZHU Xuming;SUN Jianming(Department of Urology,the 904th Hospital of the PLA Joint Logistic Support Force,Jiangsu Province,Wuxi 214000,China)
出处
《中国医药导报》
CAS
2021年第15期79-83,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81560408)。
关键词
输尿管嵌顿性结石
多因素
微创经皮肾镜技术
结石清除率
Incarcerated ureteral stones
Multiple factors
Minimally invasive percutaneous nephrolithotomy
Stone removal rate
