摘要
目的分析经皮肾镜碎石取石术(PCNL)后结石残留的危险因素。方法选取2015年6月至2020年6月九江学院附属医院收治的156例符合PCNL治疗指征的肾结石患者为研究对象。患者均给予PCNL手术治疗,术前利用泌尿系CT平扫资料测量患者S.T.O.N.E.评分系统里的各项指标,根据测量结果进行评分;术后给予腹部平片检查,依据是否存在结石残留进行分组。采用logistic分析结石清除效果与S.T.O.N.E.评分的关系。结果156例患者经PCNL治疗后纳入结石清除组患者127例,纳入结石残留组患者29例。经logistic回归分析显示:结石残留组、最大截面积、受累肾盏数和通道宽度方面均大于结石清除组,皮肾通道距离短于结石清除组,结石残留组在S.T.O.N.E.评分系统总分、S评分和N评分方面与结石清除组比较,差异有统计学意义(P<0.05)。多因素分析结果显示,S.T.O.N.E.评分(β=0.080,OR=2.429,95%CI:1.769~3.881)、S评分(β=0.088,OR=2.691,95%CI:1.639~3.169)、N评分(β=0.048,OR=4.206,95%CI:2.698~6.224)是术后结石残留的危险因素。结论S.T.O.N.E.评分系统总分越高,PCNL结石清除效果越差,在评估患者术后是否残留结石方面具有较高的应用价值。
Objective To analyze the risk factors of residual stone after percutaneous nephrolithotomy(PCNL).Methods A total of 156 patients with kidney stones conforming to the treatment indications of PCNL admitted to the Affiliated Hospital of Jiujiang University from June 2015 to June 2020 were selected as the study objects.All patients were treated with PCNL surgery.The patients'S.T.O.N.E was measured by CT scan of urinary system before operation.The indicators in the scoring system were scored according to the measurement results.Abdominal radiographs were taken after operation,and the patients were grouped according to the presence or absence of stone residue.Logistic regression equation was used to analyze the effect of stone removal and S.T.O.N.E score.Results Of 156 patients treated with PCNL,127 patients were included in the stone removal group and 29 were included in the stone residual group.Logistic regression equation analysis showed that the stone residual group,the maximum cross-sectional area,the number of involved calices and the width of channels were greater than those in the stone removal group,the distance of the cutaneous and renal channels was shorter than that in the stone removal group,and the stone residual group was in S.T.O.N.E.The total score,S score and N score of the scoring system were significantly different from those of the stone removal group(P<0.05).The results of multivariate analysis indicated that S.T.O.N.E.score(β=0.080,OR=2.429,95%CI:1.769-3.881),S score(β=0.088,OR=2.691,95%CI:1.639-3.169),N score(β=0.048,OR=4.206,95%CI:2.698-6.224)were the risk factors for postoperative stone residue.Conclusion The higher the total score of S.T.O.N.E.score system,the worse the stone removal effect of PCNL,which has high application value in evaluating whether patients have residual stones after surgery.
作者
黄玉清
张良
周海滨
HUANG Yuqing;ZHANG Liang;ZHOU Haibin(Department of Urology,Affiliated Hospital of Jiujiang University,Jiangxi Province,Jiujiang332000,China)
出处
《中国当代医药》
CAS
2023年第27期68-71,共4页
China Modern Medicine
基金
江西省卫生计生委科技计划项目(20197193)。
