肾绞痛后输尿管结石自排患者临床特点研究

发布时间：2018-06-25 22:17

  本文选题：输尿管结石 + 肾绞痛　； 参考：《石河子大学》2014年硕士论文

【摘要】：目的：输尿管结石发病率和患病率逐年增加，其大多数可自行排出，但目前预测输尿管结石排出的方法尚不完善。拟通过本前瞻性研究来发现输尿管结石致肾绞痛患者的临床特点，，并探讨患者一般情况、实验室检查和影像学资料在预测输尿管结石自行排出时的临床应用价值。 方法：收集2013年1月至8月因肾绞痛就诊于我院泌尿外科门诊的患者的临床资料。患者的临床资料包括一般情况，实验室检查及影像学资料。所有符合诊断标准和纳入标准的患者均接受相同的药物治疗。一个月后复查泌尿系超声或CT并根据患者结石的排出情况分为排石组和未排石组。使用单因素分析及多因素Logistic回归分析来筛选预测因素。 结果：共入选275名患者，233名（64.36%）患者完成研究。患者的年龄平均为41.77±14.86岁，男女比为3.1:1，其中138名（59.23%）患者4周内结石自行排出。结石≤0.6cm的肾积水程度明显小于结石0.6cm组，且差异具有统计学意义（P0.01）。输尿管上段、中段、下段和膀胱壁内段的结石平均大小为(0.78±0.16)cm、(0.76±0.15)cm、(0.69±0.14)cm和(0.74±0.19)cm，且差异具有统计学意义（P0.05），使用LSD-t检验法进行组间的多重比较，发现输尿管上段结石和下段结石的差异仍具有统计学差异（P0.01）。疼痛程度为中度、重度和极重度的患者结石平均大小分别为(0.85±0.11)cm、(0.74±0.15)cm和(0.63±0.14)cm且差异具有统计学意义（P0.05），使用LSD-t检验法进行组间多重比较，发现三组间的差异仍有统计学意义（P0.05）。结石位于输尿管上段、中段、下段及膀胱壁内段的镜下血尿发生率分别为62.50%、30.00%、66.20%和42.10%，且这种差异有统计学意义（P0.05）。单因素分析发现排石组和未排石组之间结石大小及位置、年龄、疼痛程度分级、血白细胞计数、中性粒细胞百分比、中性粒细胞计数、淋巴细胞百分比和CRP有统计学差异（P0.05），多因素Logistic回归分析发现血白细胞计数、CRP、结石大小及位置是有统计学意义的因素（P0.05）。 结论：疼痛程度分级越高，输尿管结石越小。而输尿管结石越大，肾盂积水程度越重。和结石大小及位置一样，血白细胞计数和CRP可能是预测输尿管结石自行排出的独立因素。
[Abstract]:Objective: the incidence and prevalence of ureteral calculi increase year by year, most of them can be discharged by themselves, but the method of predicting ureteral calculi is not perfect. The purpose of this prospective study was to find out the clinical features of renal colic caused by ureteral calculi, and to explore the clinical application value of general condition, laboratory examination and imaging data in predicting the spontaneous discharge of ureteral calculi. Methods: from January to August, 2013, the clinical data of patients with renal colic in Urology outpatient department of our hospital were collected. The clinical data of the patients include general information, laboratory examination and imaging data. All patients who met the diagnostic criteria and the inclusion criteria received the same medication. One month later, the urological ultrasound or CT was reexamined and divided into two groups according to the excretion of stone. Single factor analysis and multivariate logistic regression analysis were used to screen predictive factors. Results: a total of 275 patients (64.36%) completed the study. The average age of the patients was 41.77 卤14.86 years old, and the ratio of male to female was 3.1: 1. 138 patients (59.23%) had stones excreted by themselves within 4 weeks. The degree of hydronephrosis in patients with stones 鈮

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