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目的:评估影响输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FUL)术后结石清除率(stone free rate,SFR)的风险因素。方法:分析260例FUL患者临床资料,将患者特征(年龄、性别、BMI、病史等)、结石特点(大小、位置和相关肾脏解剖、成分等)、FUL参数(输尿管通道鞘、灌注、碎石时间和手术时间等)作为潜在风险因素分组进行单因素分析,随后通过多因素逻辑回归分析,计算Odds比值(OR)和95%可信区间(95%CI),以确定FUL术后SFR降低的独立风险因素。结果:本组FUL术后SFR为73.5%。多因素逻辑回归分析中,结石大小(OR=8.636,95%CI:4.594~16.236,P<0.001)、肾下盏结石(OR=9.892,95%CI:4.463~21.923,P<0.001)、经皮肾镜取石(PCNL)术后残留结石(OR=4.632,95%CI:1.715~12.512,P=0.002)及感染性结石(OR=2.302,95%CI:1.000~5.305,P=0.050)被确定为FUL术后SFR降低的独立风险因素。结论:对于大负荷结石、肾下盏结石、PCNL术后残留结石、感染性结石,FUL术后SFR将会有降低的风险。
Objective: To evaluate the risk factors of stone free rate (SFR) after flexible ureteroscopic lithotripsy (FUL). Methods: The clinical data of 260 patients with FUL were analyzed. The characteristics of the patients (age, sex, BMI, medical history, etc.), The characteristics of the stones (size, location and related renal anatomy, Time and operation time) were grouped as potential risk factors for univariate analysis. Odds odds ratio (OR) and 95% confidence interval (95% CI) were then calculated by multivariate logistic regression analysis to determine the reduction in SFR after FUL Independent risk factors. Results: The FUL postoperative SFR was 73.5%. In multivariate logistic regression analysis, the size of stones (OR = 8.636,95% CI: 4.594-16.236, P <0.001), calcification of lower kidney stones (OR = 9.892, 95% CI: 4.463-21.923, P <0.001) Residual stones (OR = 4.632, 95% CI: 1.715-12.512, P = 0.002) and infective stones (OR = 2.302, 95% CI: 1.000-5.305, P = 0.050) after PCNL were Determined as a reduction in SFR after FUL independent risk factors. CONCLUSIONS: There is a reduced risk of SFR after heavy load stones, subcalibal calculus, residual stones after PCNL, infectious stones, and FUL.