输尿管结石行体外冲击波碎石治疗后发生输尿管狭窄的危险因素分析

Analysis on the risk factors of ureteral stenosis after extracorporeal shock wave lithotripsy for ureteral calculi

目的探讨输尿管结石经体外冲击波碎石治疗后发生狭窄的危险因素。方法收集2006年7月至2011年7月就诊于我院首次行体外冲击波碎石治疗的输尿管结石患者的临床资料,先对所取临床指标进行单因素分析,然后进行Logistic多因素回归分析。结果共收集行体外冲击波碎石的输尿管结石患者174例,其中发生术后输尿管狭窄的患者15例,狭窄发生率为8.62%,单因素分析显示:结石长径、肾积水程度、结石嵌顿时间以及碎石次数与术后输尿管狭窄发生相关,多因素Logistic回归分析结果显示:结石长径、肾积水程度以及碎石次数是患者发生输尿管狭窄的独立危险因素。结论对于肾积水程度较重、结石长径较大、预期碎石次数较多的输尿管结石患者,行体外冲击波碎石后发生狭窄的可能性相对较高,在治疗选择上应更加慎重,提倡选择体外冲击波碎石之外更加安全有效的治疗方式。

Objective To investigate the risk factors of ureteral stenosis in patients with ureteral calculi treated by extracorporeal shock wave lithotripsy （ESWL）.Methods The clinical data of 174 cases of ureteral calculi treated with ESWL the first time in our hospital during July 2006 to July 2011 were collected and reviewed.All indexes were analyzed with univariate analysis and logistic multivariate regression.Results Of the 174 patients,15 （8.62%） developed ureteral stenosis after ESWL therapy.Univariate analysis showed that diameter of stone,degree of hydronephrosis,time of stone incarceration,and number of ESWL were associated with ureteral stricture after ESWL.Logistic regression indicated that diameter of stone,degree of hydronephrosis and number of ESWL were the risk factors.Conclusions The patients with large stones,complicated with severe hydronephrosis,and needing multi-ESWL,were more likely to develop ureteral stenosis after ESWL therapy.In such cases,safer and more effective treatment other than ESWL should be considered.