摘要
目的探讨嵌顿性结石合并输尿管周围病变的影响因素。方法回顾性分析2018年9月-2021年4月天津医科大学第二医院收治的438例嵌顿性输尿管结石患者的临床资料。采用单因素和多因素Logistic分析方法,评估嵌顿性结石合并输尿管周围病变的影响因素,受试者工作特征曲线(ROC)分析最佳危险因素截点值。同时,根据输尿管病变的类型进行分组,并统计分析组间的临床数据。结果嵌顿性结石合并输尿管周围病变发病率为68.9%。病变组与非病变组在结石侧别、肾积水程度、结石密度以及输尿管壁厚度(UWT)方面差异具有统计学意义(P<0.05);结石密度以及UWT是嵌顿性结石合并输尿管周围病变的独立危险因素(P<0.05);UWT为最佳预测因素,ROC截点值为2.78 mm。息肉组与狭窄组之间的临床指标差异无统计学意义。结论结石密度和UWT是嵌顿性结石合并输尿管周围病变的独立危险因素;UWT为预测最佳因素,UWT≥2.78 mm,高度怀疑输尿管结石周围合并息肉或狭窄。
Objective To investigate the risk factors of ureteral lesions related to impacted stones.Methods The clinical data of 438 patients with impacted stones treated in our hospital during Sep.2018 and Apr.2021 were retrospectively analyzed.Risk factors for ureteral lesions were assessed with univariate and multivariate analysis.The cut-off values of the predictive factors were determined with receiver-operating characteristic(ROC)curve.Patients were divided into 2 groups according to the type of ureteral lesions,and the differences were compared.Results Ureteral lesions were related to impacted stones,with an incidence of 68.9%.The side of the stones,degree of hydronephrosis,stone density,and ureteral wall thickness(UWT)had statistical significance(P<0.05).Stone density and UWT were the independent risk factors(P<0.05).UWT was the best predictor,and the cut-off value was 2.78 mm.There were no statistical significances between the polyp and stricture groups.Conclusion Stone density and UWT are the independent risk factors for ureteral lesions with impacted stones.UWT is the best predictor.When the cut-off value of UWT is≥2.78 mm,polyps or strictures surrounding ureteral calculi are highly suspected.
作者
李智
沈冲
吴周亮
胡海龙
齐士勇
LI Zhi;SHEN Chong;WU Zhouliang;HU Hailong;QI Shiyong(Department of Urology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China)
出处
《现代泌尿外科杂志》
CAS
2022年第2期109-114,共6页
Journal of Modern Urology
基金
天津市自然科学基金(No.17ZXMFSY00060)
天津市自然科学基金(No.18PTLCSY00010)
天津医科大学第二医院重点实验室科研基金(No.2017ZDSYS14)。
关键词
尿石症
嵌顿性输尿管结石
输尿管镜
输尿管息肉
输尿管狭窄
输尿管周围病变
urolithiasis
impacted ureteral stone
ureteroscopy
ureteral polyps
ureteral stricture
ureteral lesions related to impacted stones
