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目的:分析与输尿管镜钬激光碎石术后致使结石残留相关的临床危险因素。方法:选取我院214例接受输尿管镜钬激光碎石术的输尿管结石患者进行回顾性分析,对14个特征性临床因素与结石残留的关系应用单因素方差分析进行评价,对存在相关性的临床因素再应用计算机COX比例风险模型进行多因素分析。结果:全组患者结石残留率为42.52%(91/214)。单因素方差分析:ESWL史、患侧肾功能、结石位置、结石最大径、击碎后最大径、术后第1日输液量、术后第1日尿量、术后下床时间、术后解痉利尿药使用与术后结石残留相关(P值均<0.05);经过COX比例风险模型检测,患侧肾功能、结石位置、击碎后最大径、是结石残留的危险因素(P<0.05),而术后第1日尿量及术后解痉利尿药使用是结石残留的保护因素(P<0.05)。结论:患侧肾功能不良、结石位于上段、击碎后直径仍大易导致残留结石,而术后第1天尿量较多且适当应用解痉利尿药能减少残留结石。
OBJECTIVE: To analyze the clinical risk factors associated with residual stones after ureteroscopic holmium laser lithotripsy. Methods: A retrospective analysis was performed on 214 patients with ureteral calculi undergoing ureteroscopic holmium laser lithotripsy. One-way analysis of variance (ANOVA) was used to evaluate the relationship between 14 characteristic clinical factors and residual stones. Factors and then use the computer COX proportional hazards model for multivariate analysis. Results: The residual rate of stones in all patients was 42.52% (91/214). One-way analysis of variance: History of ESWL, ipsilateral renal function, location of stone, maximum diameter of stone, maximum diameter after crush, volume of fluid on the first day after operation, urine output on the first day after operation, time to bed after operation, The use of antispasmodic and diuretic drugs was related to residual stones after operation (all P <0.05). After COX proportional hazards model test, ipsilateral renal function, location of stones and the maximum diameter after crushing were the risk factors of residual stones (P <0.05 ), While the amount of urine on day 1 and the use of antispasmodic diuretics after operation were the protective factors of residual stones (P <0.05). Conclusion: The ipsilateral renal dysfunction, stones in the upper segment, the diameter is still large after crushing easily lead to residual stones, and more urine on the first day after surgery and the appropriate application of antispasmodic diuretics can reduce residual stones.