摘要目的:分析泌尿外科输尿管软镜治疗肾结石术后结石残留的影响因素,并提出相关预防措施。方法:回顾性分析2014年1月~2016年12月行输尿管软镜治疗的肾结石患者临床资料,根据术后是否残留结石将其分为残留组与无残留组,单因素及Logistic多因素回归分析术后结石残留原因。结果:残留组与无残留组在结石≥2 cm(71.11% vs. 58.13%)、结石负荷>400 mm2(42.22% vs. 28.12%)、手术时间>100 min(36.67% vs. 23.12%)、结石部位(下盏比例55.56% vs. 13.75%)、结石成分(一水草酸钙结石比例66.67% vs. 31.25%)方面比较差异有统计学意义(P<0.05);Logistic回归分析显示输尿管软镜术后结石残留独立危险因素包括结石负荷、结石部位、结石成分。结论:肾结石患者经输尿管软镜治疗后结石残留与结石部位、结石负荷等密切相关,建议熟悉掌握输尿管软镜处理适应证,针对可能导致结石残留因素采取相应措施。
Abstract：Objective:To analyze the influencing factors of postoperative residual stones after treatment with flexible ureteroscope in urology department, and put forward relevant preventive measures. Methods:The clinical data of patients with renal calculi who were treated with flexible ureteroscope in the urology department of our hospital between January 2014 and December 2016 were retrospectively analyzed. According to the status of postoperative residual stones, the patients were divided into the residue group and non-residue group. The causes of postoperative residual stones were analyzed by univariate and Logistic multivariate regression analysis. Results:There were significant differences between the residue group and non-residue group in stone size ≥ 2 cm (71.11% vs. 58.13%), stone burden >400 mm2 (42.22% vs. 28.12%), operation time > 100 min (36.67% vs. 23.12%), stone location (ratio of lower calyx, 55.56% vs. 13.75%) and stone composition (ratio of calcium oxalate monohydrate, 66.67% vs. 31.25%) (P<0.05). Logistic regression analysis showed that the risk factors for residual stones after treatment with flexible ureteroscope included stone burden, stone location and stone composition. Conclusions:The incidence of residual stones in patients with renal calculi after treatment with flexible ureteroscope is closely related to stone location and stone burden. It is suggested that the indications of treatment with flexible ureteroscope should be grasped to take corresponding measures according to the causes of residual stones.
庞松强, 罗功唐, 宋瑶, 杨金强, 陶然. 输尿管软镜处理肾结石术后结石残留的影响因素及预防措施分析[J]. 微创泌尿外科杂志, 2017, 6(3): 150-153.
Pang Songqiang, Luo Gongtang, Song Yao, Yang Jinqiang, Tao Ran. Influencing factors and preventive measures of residual stones after treatment with flexible ureteroscope. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(3): 150-153.
