钬激光碎石术治疗输尿管结石后发生输尿管狭窄的危险因素分析

Analysis of risk factors of stenosis after holmium laser lithotripsy for ureteral stones

目的探讨钬激光碎石术治疗输尿管结石后发生输尿管狭窄的危险因素。方法回顾性分析2010年2月至2013年2月行钬激光碎石术治疗输尿管结石的264例患者资料,按照术后随访结果将患者分为输尿管狭窄组以及非狭窄组,对两组患者各资料首先采取单因素分析,然后进一步采取非条件Logistic多因素回归分析。结果 264例患者术后随访6~21个月,术后发生输尿管狭窄患者16例,术后输尿管结石狭窄率为6.06%;单因素分析结果显示,两组患者在病程、结石长径、肾积水程度以及结石嵌顿四个因素上差异具有统计学意义（P〈0.05）;对上述单因素分析具有统计学意义的四个因素进行多因素Logistic回归分析,结果显示,结石嵌顿、病程以及结石长径进入Logistic回归模型（P〈0.05）。结论输尿管结石患者中结石嵌顿、病程较长以及结石长径较大的患者,其经输尿管镜钬激光碎石后发生输尿管狭窄的风险增高,需要引起临床工作者的重视。

Objective To analyze the risk factors of stenosis after holmium laser lithotripsy for ureteral stones. Methods Retrospectively analyzed 264 cases of holmium laser lithotripsy for ureteral stones operated in our hospital from February 2010 to February 2013. According to the follow - up results, the patients were divided into restenosis group and non - stenosis group, the data of the two groups of patients were analyzed first with single factor analysis, and then with multiple - factor non - conditional logistic regression analysis. Results Of the 264 patients who were followed - up for 6 - 21 months after operation, 16 had ureteral stricture, postoperative stenosis rate was 6.06%. The single - factor analysis showed that there were significant differences in the course of disease, stone size, the degTee of hydronephresis and stone incarceration between two groups of patients （ P 〈 0.05 ）. The multivariate logistic regression analysis results showed that the calculus incarceration, course of disease and stone size were in the logistic regression model （ P 〈 0.05 ）. Conclusion The patients who have stone incarceration, larger diameter stone and long duration of disease are at increased risk of ureteral stenosis after transureteroscopic holmium laser lithotripsy.