输尿管结石患者肾积水程度的影响因素分析

目的探讨输尿管结石患者肾积水程度的影响因素。方法输尿管结石患者392例，其中77例因病情复杂进一步行CT检查，确定年龄、性别，结石位置，有无多发结石，结石大小，BMI，有无同侧肾结石，有无临床症状为研究变量，采用logistic回归进行多因素分析。结果B超检测输尿管结石的敏感性90．7％，检测肾积水的敏感性93．5％，有肾积水与无肾积水条件下B超检测结石敏感性分别912％、72．0％，77例行CT检查的患者中，无或轻度肾积水63例（81．8％），中重度肾积水14例（18．2％），logistic回归分析提示多发结石及结石大小是肾积水加重的危险因素，其作用大小依次为：多发结石（OR=18．103）、结石大小（OR=I．158）。年龄、性别、结石位置、BMI、有无同侧肾结石无影响。结论肾积水提高B超检测输尿管结石的敏感性，多发结石和结石〉10mm是导致中重度肾积水的危险因素，结石数量越多、体积越大，肾积水越严重，但是多发结石影响力较强。

Objective To investigate the clinical factors which affected greed ofhydronephrosis in patients with ureteral calculus. Methods 392 patients with ureteral calculus from May 1st 2014 to Jun 1st 2015 were prospectively study, among whom 77 patient accepted CT scan. Patients＇s age, gender, stone location, multiple stone, stone size, BMI, lpsilateral renal stone and symptoms were choose as research variable. Logistic multivariate model was used to analyse factors. Results The sensitivity of B ultrasonic on ureteral calculus and hydronephrosis diagnosis was 90.7% and 93.5% respectively. The sensitivity of B ultrasonic was 91.2% under the condition ofhydronephrosis, but 72.0% without hydronephrosis. Logistic regression analysis indicates multiple stone （ OR=18.103 ） and stone size （ OR=1. 158 ） were two important factors of hydronephrosis. Conclution Hydronephrosis can improve sensitivity of B ultrasonic on detecting ureteral calculus. Multiple stone and stone size〉l 0mm are hazards lead to moderately and severe hydronephrosis. More amounts of stones and larger stone size is correlated with hydronephrosis degree, but multiple stone has stronger effects.