体外冲击波碎石术治疗尿路结石的并发症影响因素调查

Survey on influencing factors of complications of extracorporeal shock wave lithotripsy for urinary calculi

目的研究体外冲击波碎石术(ESWL)治疗尿路结石的并发症影响因素。方法回归分析350例尿路结石行ESWL术患者临床资料及术后并发症情况,采用单因素、多因素及ROC曲线进行分析并发症影响因素。结果上尿路并发症组和对照组年龄、性别、身高、体质量指数、结石位置、结石数、结石长径、结石宽径、病程、冲击次数之间差异有统计学意义(P<0.05),下尿路并发症组和对照组年龄、性别、体重、结石数、结石长径、结石宽径、冲击次数、冲击能量之间差异有统计学意义(P<0.05)。Logistic回归分析,结石数、结石位置、结石长径、冲击次数对上尿路结石ESWL术后并发症影响显著(P<0.05),结石数、结石长径、结石宽径、冲击次数、冲击能量对下尿路结石ESWL术后并发症影响显著(P<0.05)。上尿路和下尿路ESWL术后并发症影响因素回归模型ROC曲线下面积分别为0.825、0.818,有统计学意义(P<0.05)。结论 ESWL术更适于治疗上尿路结石,结石数、结石位置、结石长径、冲击次数是影响上尿路结石ESWL术后并发症重要因素,结石数、结石长径、结石宽径、冲击次数、冲击能量是影响下尿路结石ESWL术后并发症重要因素。

Objective To study the influencing factors of complications of extracorporeal shock wave lithotripsy for urinary calculi. Methods Regression analysis of clinical data and postoperative complications of 350 cases of urinary tract stones line ESWL surgery patients, done the single factor, multi-factor and the ROC curve analysis of influencing factors for com- plications. Results The differences of age, gender, height, body mass index, stone location, number of stones, stone diame- ter, stone width, duration, the impact times between upper urinary tract complications group and control group were statisti- cally significant （P 〈 0.05）; the differences of age, gender, weight, stone number, stone length, stone width, impact energy between lower urinary tract complications and control groups were statistically significant （P 〈 0.05）. Logistic regression analysis, the number of stones, stone location, stone diameter, the impact times of upper urinary tract calculi ESWL postop- erative complications were significant （P 〈 0.05）; number of stones, stone diameter, stone width, impact times, the impact energy lower urinary tract stones ESWL postoperative complications were significant （P 〈 0.05）. ESWL postoperative compli- cations of upper urinary tract and lower urinary tract affect the area under the ROC curve regression model were 0.825, 0.818, had statistical significance （P 〈 0.05）. Conclusion ESWL technique is more suitable for the treatment of urinary tract stones; stone nmnber, stone location, stone length, the number of impact are the important factors in urinary calculi ESWL postoperative complications; the stone number, stone length, stone width, impact frequency and impact energy are the im- portant factors under the influence of ESWL postoperative complications of urolithiasis.