现代泌尿外科杂志
現代泌尿外科雜誌
현대비뇨외과잡지
Journal of Modern Urology
2015年
8期
561-565,576
,共6页
朱池海%廖邦华%朱育春%曹祥明%李虹%王坤杰%魏鑫%罗德毅
硃池海%廖邦華%硃育春%曹祥明%李虹%王坤傑%魏鑫%囉德毅
주지해%료방화%주육춘%조상명%리홍%왕곤걸%위흠%라덕의
输尿管石街%输尿管软镜%上尿路结石
輸尿管石街%輸尿管軟鏡%上尿路結石
수뇨관석가%수뇨관연경%상뇨로결석
steinstrasse%ureteroscopy%urinary stone
目的 评价输尿管软镜钬激光碎石术的疗效及安全性,探索输尿管软镜钬激光碎石术后石街的发生率及其危险因素.方法 本前瞻性研究纳入2013年5月至2013年12月四川大学华西医院泌尿外科行输尿管软镜钬激光碎石术的患者共156例.采集患者年龄、性别等人口学信息,结石大小、部位和数量,发热、出血、下尿路刺激症状等术后并发症.采用 Logistic回归分析评估石街的危险因素.结果 输尿管软镜钬激光碎石术治疗肾或输尿管上段结石的I期结石清除率为83.3% 、Ⅱ期结石清除率为98.1%.需进行干预的术后并发症包括发热10例(6.4% )、下尿路刺激症状2例(1.2% )、出血1例(0.6% )等,其总体发生率为8.2%.术后石街发生率为5.8%.以结石累积最大径线(CSD)为例,进行分层分析发现,CSD<10 mm、10~20 mm、20~30 mm、>30 mm的患者石街形成率分别为0% 、4.9% 、17.4% 、20.0%.Logistic回归分析发现:石街与结石负荷、患者性别、年龄、患肾GFR、尿路感染、结石位置、碎石时间等均没有相关性(P>0.05).结论 输尿管软镜钬激光碎石术治疗肾或输尿管上段结石是有效且安全的.人口学特征、患肾功能、结石部位及负荷等因素均不是术后石街发生的危险因素.
目的 評價輸尿管軟鏡鈥激光碎石術的療效及安全性,探索輸尿管軟鏡鈥激光碎石術後石街的髮生率及其危險因素.方法 本前瞻性研究納入2013年5月至2013年12月四川大學華西醫院泌尿外科行輸尿管軟鏡鈥激光碎石術的患者共156例.採集患者年齡、性彆等人口學信息,結石大小、部位和數量,髮熱、齣血、下尿路刺激癥狀等術後併髮癥.採用 Logistic迴歸分析評估石街的危險因素.結果 輸尿管軟鏡鈥激光碎石術治療腎或輸尿管上段結石的I期結石清除率為83.3% 、Ⅱ期結石清除率為98.1%.需進行榦預的術後併髮癥包括髮熱10例(6.4% )、下尿路刺激癥狀2例(1.2% )、齣血1例(0.6% )等,其總體髮生率為8.2%.術後石街髮生率為5.8%.以結石纍積最大徑線(CSD)為例,進行分層分析髮現,CSD<10 mm、10~20 mm、20~30 mm、>30 mm的患者石街形成率分彆為0% 、4.9% 、17.4% 、20.0%.Logistic迴歸分析髮現:石街與結石負荷、患者性彆、年齡、患腎GFR、尿路感染、結石位置、碎石時間等均沒有相關性(P>0.05).結論 輸尿管軟鏡鈥激光碎石術治療腎或輸尿管上段結石是有效且安全的.人口學特徵、患腎功能、結石部位及負荷等因素均不是術後石街髮生的危險因素.
목적 평개수뇨관연경화격광쇄석술적료효급안전성,탐색수뇨관연경화격광쇄석술후석가적발생솔급기위험인소.방법 본전첨성연구납입2013년5월지2013년12월사천대학화서의원비뇨외과행수뇨관연경화격광쇄석술적환자공156례.채집환자년령、성별등인구학신식,결석대소、부위화수량,발열、출혈、하뇨로자격증상등술후병발증.채용 Logistic회귀분석평고석가적위험인소.결과 수뇨관연경화격광쇄석술치료신혹수뇨관상단결석적I기결석청제솔위83.3% 、Ⅱ기결석청제솔위98.1%.수진행간예적술후병발증포괄발열10례(6.4% )、하뇨로자격증상2례(1.2% )、출혈1례(0.6% )등,기총체발생솔위8.2%.술후석가발생솔위5.8%.이결석루적최대경선(CSD)위례,진행분층분석발현,CSD<10 mm、10~20 mm、20~30 mm、>30 mm적환자석가형성솔분별위0% 、4.9% 、17.4% 、20.0%.Logistic회귀분석발현:석가여결석부하、환자성별、년령、환신GFR、뇨로감염、결석위치、쇄석시간등균몰유상관성(P>0.05).결론 수뇨관연경화격광쇄석술치료신혹수뇨관상단결석시유효차안전적.인구학특정、환신공능、결석부위급부하등인소균불시술후석가발생적위험인소.
Objective To evaluate the efficacy and safety of flexible ureteroscopy (f-URL),and explore the risk factors of steinstrasse (SS) after this treatment.Methods A total of 156 patients treated with f-URL during May and Dec.2013 were involved.Characteristics of patients,stones and complications were recorded.Statistical analysis was performed to detect the predictive factors for the formation of SS.Results The overall stone-free rate was 98.1%.The incidence of complica-tions was 8.2%,including fever in 10 cases,lower urinary tract symptoms (LUTs) in 2 cases,and hemorrhage in 1 case.After f-URL,9 patients suffered SS,8 of them had renal stones and 1 had ureteral stones.The total incidence of SS was 5.8%.The SS located in proximal ureter was 4,midureter was 1 and distal ureter was 4.The incidences of SS with stone surface area <10 mm,10~20 mm,20~30 mm,and >30 mm were 0%,4.9%,17.4%,and 20.0%,respectively.Statistical analysis indicated that formation of SS was not related to stone burden,stone location,sex,age,GFR,UTIs and time of lithotripsy.Conclu-sion Ureteroscopy for urinary stones produce good stone-free rate with low morbidity.Characteristics of patients,renal function,stone burden and location are not risk factors of SS.
