摘要
目的探讨影响超微通道经皮肾镜取石术(SMP)结石清除率(SFR)的术前因素。方法回顾性分析2017年3月-2021年9月于郑州大学第二附属医院泌尿外科接受SMP治疗的257例上尿路结石患者的临床资料,根据术后有无结石残留将患者分为清石组(227例)和残石组(30例)。对可能引起结石残留的相关因素进行单因素分析,再对有统计学意义的指标进行logistic回归分析。结果257例患者中,总SFR为88.3%。单因素分析显示,两组患者在患肾手术史、术前穿刺造瘘、解剖畸形、结石负荷、结石形态与分布的比较中,差异有统计学意义(P<0.05)。logistic回归分析显示,存在解剖畸形、结石形态与分布高分级(Ⅱ级、Ⅲ级)、结石负荷大(≥8000 mm^(3))为SMP术后结石残留的独立危险因素(P<0.05)。结论SMP的SFR受上述多个术前因素综合作用的影响。术前根据患者有无解剖畸形、结石形态与分布以及结石负荷,可对SMP方案进行选择,同时对SMP的SFR进行初步预测。
Objective To explore the preoperative factors affecting the stone-free rate(SFR)after super-mini percutane⁃ous nephrolithotomy(SMP).Methods Clinical data of 257 patients with upper urinary calculi treated with SMP in our hospital during Mar.2017 and Sep.2021 were retrospectively analyzed.The patients were divided into non-residual group(227 cases)and residual group(30 cases)according to whether there was residual stone after operation.The related factors that might cause residual stones were analyzed with univariate analysis,and statistically significant factors were selected for multivariate logistic regression analysis.Results The total SFR was 88.3%.Univariate analysis showed significant difference between the two groups in previous stone surgery history,preoperative puncture fistula,anatomical deformities,volume of calculi,morphology and distribution of calculi(P<0.05).Multivariate logistic analysis showed anatomical deformities,volume of calculi(≥8000 mm^(3)),and morphology and distribution of calculi(GradeⅡandⅢ)were independent risk factors for residual stones after SMP(P<0.05).Conclusion The SFR of patients treated with SMP is affected by multiple factors.Before operation,according to ana⁃tomical deformities,morphology,distribution and volume of calculi,the SMP program can be selected and SFR can be pre⁃dicted.
作者
李强
许长宝
赵兴华
李武学
LI Qiang;XU Changbao;ZHAO Xinghua;LI Wuxue(Department of Urology,The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《现代泌尿外科杂志》
CAS
2022年第4期281-285,共5页
Journal of Modern Urology
基金
河南省医学科技攻关计划项目(No.LHGJ20190322)。
