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输尿管镜钬激光碎石术中输尿管损伤的因素分析 预览

Risk factors for ureteral injury in ureteroscopic holmium laser lithotripsy
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摘要 目的探讨输尿管镜钬激光碎石术中输尿管损伤的危险因素及其防治措施。方法收集589例接受输尿管镜钬激光碎石术治疗的患者资料,根据术中是否有输尿管损伤分为损伤组(n=26)和未损伤组(n=563),对两组患者的临床资料进行对比分析。结果两组患者年龄、性别、病程、结石部位、肾积水程度、合并糖尿病等资料对比,差异均无统计学意义(P>0.05);两组患者结石直径、结石嵌顿率、合并输尿管息肉率、结石CT值、术前无预置管率及预扩张时间等指标对比,差异有统计学意义(P<0.05);两组手术时间对比,差异有统计学意义(P<0.05)。Logistic回归分析:结石直径、结石CT值、结石嵌顿、合并输尿管息肉、术前无预置管及预扩张时间是碎石术过程中发生输尿管损伤的危险因素。结论结石直径过大、结石CT值高、结石嵌顿、合并输尿管息肉、术前无预置管及预扩张时间过短是输尿管镜碎石术过程中发生输尿管损伤的危险因素,对这类患者需引起重视。 Objective To explore the risk factors and their prevention measures of ureteral injury in ureteroscopic holmium laser lithotripsy.Methods The data of 589 patients treated with uretero-scopic holmium laser lithotripsy were collected and divided into injury group(n=26)and uninjured group(n=563)according to the presence of intraoperative ureteral injury.The clinical data of the two groups were compared and analyzed.Results There were no statistically significant differences in age,gender,course of disease,location of calculi,severity of hydronephrosis,or complication of diabetes mellitus between the two groups(P>0.05);statistically significant differences were observed between the two groups in indicators such as calculus diameter,calculus incarceration rate,rate of complication of ureteral polyp,CT value of calculus,rate of absence of preoperative preset catheter,and predilation time(P<0.05).There was statistically significant difference in operation duration between the two groups(P<0.05).Logistic regression analysis showed that calculus diameter,CT value of calculus,calculus incarceration,complication of ureteral polyp,absence of preoperative preset catheter,and predilation time were risk factors for developing ureteral injury during lithotripsy.Conclusion Excessively greater calculus diameter,high CT value of calculus,calculus incarceration,complication of ureteral polyp,absence of preoperative preset catheter,and excessively shorter predilation time are risk factors for developing ureteral injury during ureteroscopic lithotripsy,and attention should be paid to these patients in clinical practice.
作者 林俊 王坚 米华 LIN Jun;WANG Jian;MI Hua(Department of Urology,the 923th Hospital of Chinese People′s Liberation Army,Nanning 530021,China;Department of Urology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处 《微创医学》 2019年第4期452-455,共4页 Journal of Minimally Invasive Medicine
基金 广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z2014539).
关键词 输尿管镜碎石术 医源性损伤 危险因素 防治策略 Ureteroscopic lithotripsy Iatrogenic injury Risk factor Prevention strategy
作者简介 通信作者:米华.
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