CAJ | 학술논문

目的：研究分析导致小儿微创经皮肾镜（MPCNL ）术后结石残留的相关危险因素。方法收集2009年1月至2014年11月在新疆维吾尔自治区人民医院泌尿外科行 MPCNL 治疗的患儿240例，根据Ⅰ期净石率分为结石清除组（202例）和结石残留组（38例），对两组间可能影响 M PCNL 术后结石残留的危险因素进行统计学分析，找出影响结石残留的危险因素。结果240例接受 MPCNL 治疗的患儿，首次净石率为84．2％（202／240）。单因素分析发现结石位置（P ＝0．001）、结石大小（P＝0．014）、结石数目（P＝0．005）与患儿 M PCNL 术后首次净石率有显著相关性，而患儿年龄、性别、患侧、肾积水程度、尿路刺激症、肾绞痛、血尿、术前感染与 M PCNL 术后结石残留无明显相关性（P＞0．05），多变量 Logistic 回归分析显示结石位置（OR ＝2．593，95％ CI ：1．228～5．475）、结石大小（OR ＝2．674，95％ CI ：1．290～5．540）、结石数目（OR ＝2．397，95％ CI ：1．145～5．019）与患儿MPCNL 术后结石残留有显著的相关性。结论结石位置、大小及数目是导致患儿 MPCNL 治疗术后残留结石的重要危险因素，术前评估患儿病情，选择合适的治疗方案。
목적：연구분석도치소인미창경피신경（MPCNL ）술후결석잔류적상관위험인소。방법수집2009년1월지2014년11월재신강유오이자치구인민의원비뇨외과행 MPCNL 치료적환인240례，근거Ⅰ기정석솔분위결석청제조（202례）화결석잔류조（38례），대량조간가능영향 M PCNL 술후결석잔류적위험인소진행통계학분석，조출영향결석잔류적위험인소。결과240례접수 MPCNL 치료적환인，수차정석솔위84．2％（202／240）。단인소분석발현결석위치（P ＝0．001）、결석대소（P＝0．014）、결석수목（P＝0．005）여환인 M PCNL 술후수차정석솔유현저상관성，이환인년령、성별、환측、신적수정도、뇨로자격증、신교통、혈뇨、술전감염여 M PCNL 술후결석잔류무명현상관성（P＞0．05），다변량 Logistic 회귀분석현시결석위치（OR ＝2．593，95％ CI ：1．228～5．475）、결석대소（OR ＝2．674，95％ CI ：1．290～5．540）、결석수목（OR ＝2．397，95％ CI ：1．145～5．019）여환인MPCNL 술후결석잔류유현저적상관성。결론결석위치、대소급수목시도치환인 MPCNL 치료술후잔류결석적중요위험인소，술전평고환인병정，선택합괄적치료방안。
Objective To investigate factors affecting residual stones in pediatric patients with the upper urinary calculi un ‐dergoing minimally invasive percutaneous nephrolithotomy (MPCNL ) and evaluate MPCNL curative effect before the operation . Methods A total of 240 children underwent MPCNL to remove the upper urinary calculi in People′s Hospital of Xinjiang Uygur Autonomous Region during the period of January 2009 to November 2014 were analyzed retrospectively .Pediatric patients were di‐vided into two groups by the stone‐free rate after the first operation :those who were stone‐free after the first operation (n= 202) as the control group and those who were residual stones (n= 38) as residual stones observation group .Then the clinical data were sta‐tistically analyzed and find out risk factors which lead to residual stone .Results The stone‐free rate after primary M PCNL was 84 . 2% (202/240) .Univariate analysis showed that stone size (P= 0 .001) ,stone location(P= 0 .014) and number of stones(P= 0 .005) were significant factors which could affect residual stones between the two groups ,while did not relate with gender ,age ,stone side , urinary irritation symptom ,hematuria ,renal colic ,preoperative infection and the degree of hydronephrosis (P > 0 .05) .Multivariate analysis showed that stone size(OR = 2 .593 ,95% CI :1 .228 - 5 .475) ,stone location(OR = 2 .674 ,95% CI :1 .290 - 5 .540)and num‐ber of stones(OR = 2 .397 ,95% CI :1 .145 - 5 .019)were independent predictors of the surgical outcome .Conclusion Stone size , stone location and number of stones are significant factors affecting residual stones in pediatric patients with the upper urinary cal ‐culi undergoing MPCNL .According to the the clinical features of pediatric patients ,we can chose suitable management of upper uri‐nary tract calculi .