摘要
目的:探讨输尿管软镜下钬激光碎石(FURS)术后结石残留的术前影响因素及其预测价值。方法:回顾性分析2015年6月至2016年9月在陕西省宝鸡市人民医院行FURS治疗的283例患者的临床资料,采用单因素及多因素Logistic回归分析方法分析影响结石残留的因素,并以受试者工作特征(ROC)曲线评价相关危险因素的预测价值。结果:一期FURS术后结石清除成功256例(清石成功组),结石残留27例(结石残留组),结石清除率(SFR)为90.46%。两组结石数量、结石部位、鹿角状结石率、菌尿率、结石累计最大径(CSD)、结石平均CT值、结石所在盏颈平均长度、肾盏横径与结石所在盏颈宽度的最大比值比较,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,鹿角状结石、CSD、结石所在盏颈平均长度、肾盏横径与结石所在盏颈宽度的最大比值是影响FURS术后结石残留的独立危险因素(P<0.05),后三者单独及联合预测FURS术后SFR的ROC曲线下面积(AUC)分别为0.840、0.642、0.816、0.874。结论:鹿角状结石、CSD、结石所在盏颈平均长度、肾盏横径与结石所在盏颈宽度的最大比值是影响FURS术后结石残留的独立危险因素,三者联合对于FURS术后SFR具有较好的预测价值。
Objective： To analyze the factors for the stone-free rate （SFR）after flexible ureteroscopy with holmium laser lithotripsy （FURS）. Methods： 283 patients with renal stones treated by FURS between June 2015 and September 2016 in our hospital were retrospectively evaluated. Factors influencing the SFR were analyzed using a logistic regression model. Results： The SFR was 90. 46% （256/283）after one-stage FURS. According to the univariate analysis, the following variables were significantly associated with SFR： The stone location, the stone number, staghorn calculi, the sterile urine, cumulative stone diameter （CSD）, the average of CT values, the average length of stone located calyx-neck, and the maximum ratio of calyx width with stone located calyx-neck＇ width （P〈0. 05）. According to the multivariate analysis, staghorn calculi, CSD, the average length of stone located calyx-neck and the maximum ratio of calyx width with stone located calyx-neck＇ width were found to be independent predictors of stone-free status. The receiver operating characteristic （ROC）curve revealed that the area under the ROC curve of CSD, the average length of stone located calyx-neck, the maximum ratio of calyx width with stone located calyx-neck＇ width and their combination were 0. 840, 0. 642, 0. 816 and 0. 874, respectively. Conclusion： CSD, the average length of stone located calyx-neck, and the maximum ratio of calyx width with stone located calyx-neck＇ width were independent risk factors for residual stones after FURS. Their combination could be a predictor of a stone-free status after FURS.
出处
《广西医科大学学报》
CAS
2017年第11期1574-1577,共4页
Journal of Guangxi Medical University
关键词
输尿管软镜
结石清除率
影响因素
flexible ureteroscope
stone-free rate
influencing factors
