肾结石患者逆行肾内结石手术后结石清除的影响因素及术前累计结石直径、结石体积的预测效能Influencing factors for stone clearance after retrograde intrarenal stone surgery in patients with nephrolithiasis and the predictive efficacy of preoperative cumulative stone diameter and stone volume on stone clearance
谷清阳;郝斌;许长宝;褚校涵;
摘要(Abstract):
目的分析肾结石患者逆行肾内结石手术(RIRS)后结石清除的影响因素及术前累计结石直径(CSD)、结石体积的预测效能。方法选取2018年6月—2020年1月郑州大学第二附属医院收治的择期行RIRS治疗的肾结石患者200例,根据RIRS术后结石清除状态分为结石清除组(167例),结石残留组(33例),采用单因素、多因素Logistic回归分析法分析肾结石患者RIRS术后结石清除的影响因素。绘制受试者工作特征曲线(ROC),分析术前CSD及结石体积预测肾结石患者RIRS术后结石清除的价值。结果结石清除组和结石残留组结石数量、CSD、结石体积比较,P均<0.05;多因素分析结果显示,CSD及结石体积是RIRS术后结石清除的影响因素。当CSD≤26 mm时,CSD与结石体积具有相似的预测能力(P<0.05);当CSD>26 mm时,CSD对于RIRS术后结石清除的预测能力低于结石体积(P<0.05)。当结石数目为1时,CSD与结石体积显示出了相似的预测价值(P>0.05);在结石数目为2~3时,CSD与结石体积显示出了相似的预测价值(P>0.05);当结石数目≥4时,CSD对于RIRS术后结石清除的评估没有统计学意义(P>0.05),结石体积仍显示出一定的预测价值(P<0.05)。结论肾结石患者RIRS术后结石清除的影响因素是CSD及结石体积;术前CSD和结石体积是CSD≤26 mm或结石数目<4肾结石患者RIRS术后结石清除的有效预测指标,结石体积是CSD>26 mm或结石数目≥4患者RIRS术后结石清除的有效预测指标。
关键词(KeyWords): 肾结石;逆行肾内手术;累计结石直径;结石体积
基金项目(Foundation): 河南省医学科技攻关计划项目(201403093)
作者(Author): 谷清阳;郝斌;许长宝;褚校涵;
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DOI:
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