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目的探讨钬激光碎石术治疗输尿管结石后发生输尿管狭窄的危险因素。方法回顾性分析2010年2月至2013年2月行钬激光碎石术治疗输尿管结石的264例患者资料,按照术后随访结果将患者分为输尿管狭窄组以及非狭窄组,对两组患者各资料首先采取单因素分析,然后进一步采取非条件Logistic多因素回归分析。结果 264例患者术后随访6~21个月,术后发生输尿管狭窄患者16例,术后输尿管结石狭窄率为6.06%;单因素分析结果显示,两组患者在病程、结石长径、肾积水程度以及结石嵌顿四个因素上差异具有统计学意义(P<0.05);对上述单因素分析具有统计学意义的四个因素进行多因素Logistic回归分析,结果显示,结石嵌顿、病程以及结石长径进入Logistic回归模型(P<0.05)。结论输尿管结石患者中结石嵌顿、病程较长以及结石长径较大的患者,其经输尿管镜钬激光碎石后发生输尿管狭窄的风险增高,需要引起临床工作者的重视。
Objective To investigate the risk factors of ureteral stricture after holmium laser lithotripsy for ureteral calculi. Methods The data of 264 patients who underwent holmium laser lithotripsy for ureteral calculi from February 2010 to February 2013 were retrospectively analyzed. According to the postoperative follow-up results, the patients were divided into ureteral stricture group and non-stricture group. Data first take univariate analysis, and then further non-conditional Logistic regression analysis. Results 264 patients were followed up for 6 to 21 months. There were 16 patients with ureteral stricture and the rate of ureteral calculi stenosis was 6.06%. The results of univariate analysis showed that the duration of disease, Water level, and stone incarceration (P <0.05). Logistic regression analysis showed that there were significant differences among the four factors in the univariate analysis. The results showed that stone incarceration, duration and The long diameter of the stone entered the Logistic regression model (P <0.05). Conclusions In patients with ureteral calculi, stone incarceration, longer course of disease, and larger diameter of stone are associated with the increased risk of ureteral stricture after ureteroscopic holmium laser lithotripsy, which needs attention of clinicians.