首次输尿管软镜碎石术中输尿管导入鞘放置困难患者的高危特征分析研究
发布时间：2018-08-18 07:57
【摘要】：目的分析首次输尿管软镜碎石术中输尿管导入鞘放置困难患者的高危临床及影像学特征。方法选取2014年9月—2016年5月郑州大学第二附属医院首次接受输尿管软镜碎石术治疗的上尿路结石患者142例(单侧119例,双侧23例),共165例次,根据患侧输尿管导入鞘放置成功与否,将其分为放置成功组和放置困难组。收集患者的临床特征和影像学特征,采用多因素Logistic回归分析患者输尿管导入鞘放置困难的影响因素。结果放置成功组118例患者,141例次;放置困难组24例患者,24例次。放置成功组和放置困难组患侧D-J管留置史、患侧输尿管镜手术史、术中扩张输尿管发生率、患侧肾萎缩、30 min静脉肾盂造影(IVP)输尿管显影程度比较,差异均有统计学意义(P0.05)。多因素Logistic回归分析结果显示,患侧D-J管留置史〔OR=0.111,95%CI(0.013,0.928)〕、患侧输尿管镜手术史〔OR=0.102,95%CI(0.012,0.867)〕是输尿管导入鞘放置成功的预测因素(P0.05),30 min IVP输尿管完全不显影〔OR=4.562,95%CI(1.388,14.992)〕是输尿管导入鞘放置困难的预测因素(P0.05)。结论 D-J管留置史及输尿管镜手术史减少输尿管导入鞘放置困难的风险,30 min IVP输尿管完全不显影增加输尿管导入鞘放置困难的风险。因此在输尿管软镜碎石术前关注患者的临床及影像学资料,可有效评估输尿管导入鞘放置困难的发生风险。
[Abstract]:Objective to analyze the high risk clinical and imaging features of difficult placement of ureteral sheath during the first lithotripsy. Methods from September 2014 to May 2016, 142 patients with upper urinary calculi (119 unilateral and 23 bilateral) who were treated with ureteral soft lithotripsy in the second affiliated Hospital of Zhengzhou University were selected for 165 times. According to the successful placement of ureteral sheath, the ureteral sheath was divided into two groups: successful placement group and difficult placement group. The clinical and imaging features of the patients were collected. Multivariate Logistic regression analysis was used to analyze the influencing factors of difficult placement of ureteral sheath. Results in the successful placement group, there were 141 cases of successful placement and 24 cases of difficult placement group. There were significant differences in the history of D-J tube indwelling, the history of ureteroscopy, the incidence of ureteral dilatation, and the degree of (IVP) ureteral development in 30 min of renal atrophy in the successful group and the difficult group (P0.05). Multivariate Logistic regression analysis showed that the indwelling history of D-J tube in the affected side was 0.111 ~ 95), (CI 0.013 ~ 0.928),). The history of ureteroscopy (ORO 0.102 ~ 95CI (0.012 ~ 0.867) was a predictor of successful ureteral sheath placement (P0.05). (P0.05) 30 min IVP ureteral failure (ORV 4.562 ~ 95CI (1.388n 14.992) was a predictor of difficult placement of ureteral sheath (P0.05). Conclusion the history of D-J tube indwelling and ureteroscopy can reduce the risk of difficult placement of ureteral sheath and increase the risk of difficult placement of ureteral sheath for 30 min IVP. Therefore, the risk of difficult placement of ureteral sheath can be effectively evaluated by paying attention to the clinical and imaging data of patients before ureteroscopic lithotripsy.
【作者单位】： 郑州大学第二附属医院泌尿外科;
【分类号】：R699
，
本文编号：2188840
[Abstract]:Objective to analyze the high risk clinical and imaging features of difficult placement of ureteral sheath during the first lithotripsy. Methods from September 2014 to May 2016, 142 patients with upper urinary calculi (119 unilateral and 23 bilateral) who were treated with ureteral soft lithotripsy in the second affiliated Hospital of Zhengzhou University were selected for 165 times. According to the successful placement of ureteral sheath, the ureteral sheath was divided into two groups: successful placement group and difficult placement group. The clinical and imaging features of the patients were collected. Multivariate Logistic regression analysis was used to analyze the influencing factors of difficult placement of ureteral sheath. Results in the successful placement group, there were 141 cases of successful placement and 24 cases of difficult placement group. There were significant differences in the history of D-J tube indwelling, the history of ureteroscopy, the incidence of ureteral dilatation, and the degree of (IVP) ureteral development in 30 min of renal atrophy in the successful group and the difficult group (P0.05). Multivariate Logistic regression analysis showed that the indwelling history of D-J tube in the affected side was 0.111 ~ 95), (CI 0.013 ~ 0.928),). The history of ureteroscopy (ORO 0.102 ~ 95CI (0.012 ~ 0.867) was a predictor of successful ureteral sheath placement (P0.05). (P0.05) 30 min IVP ureteral failure (ORV 4.562 ~ 95CI (1.388n 14.992) was a predictor of difficult placement of ureteral sheath (P0.05). Conclusion the history of D-J tube indwelling and ureteroscopy can reduce the risk of difficult placement of ureteral sheath and increase the risk of difficult placement of ureteral sheath for 30 min IVP. Therefore, the risk of difficult placement of ureteral sheath can be effectively evaluated by paying attention to the clinical and imaging data of patients before ureteroscopic lithotripsy.
【作者单位】： 郑州大学第二附属医院泌尿外科;
【分类号】：R699
，
本文编号：2188840
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