体外冲击波碎石治疗下尿路结石的临床疗效及并发症的影响因素分析

Clinical Efficacy of Extracorporeal Shock Wave Lithotripsy in the treatment of Lower Urinary Calculi and Analysis of the Factors Influencing the Complications

目的:探讨体外冲击波碎石治疗下尿路结石的临床疗效及并发症的影响因素分析。方法:回顾性分析2000年1月至2017年10月我院的900例下尿路结石患者,观察所有患者治疗次数,碎石排净情况,治疗时间,住院时间,治疗疗效,并发症情况,并发症影响因素Logistic回归分析。结果:990例患者中,1次碎石排净者410例,占45.55%;2次碎石排净者273例,占30.33%;3次碎石排净者161例,占17.88%。手术时间30~70min,平均(52.39±3.10)min;随访6个月显示,治愈519例(57.66%),有效325例(36.11%),无效56例(6.22%),总有效率为93.77%(844/900);900例患者中,658例有并发症,242例无并发症,两组之间体质量指数、结石长径、结石宽径、冲击次数、冲击能量存在显著差异(P<0.05);在下尿路结石术后并发症影响因素Logistic回归分析中,结石长径、结石宽径、冲击次数、冲击能量均是下尿路结石术后的并发症影响因素(P<0.05)。结论:体外冲击波碎石治疗下尿路结石的临床疗效显著,术后并发症的可能因素主要在于结石长径、结石宽径、冲击次数、冲击能量,冲击次数越多并发症的概率越大。在临床应用中应严格掌握适应症及操作流程,减少、避免并发症的发生,以获得更好的临床疗效及安全性。

Objective:To study clinical efficacy of extracorporeal shock wave lithotripsy in the treatment of lower urinary calculi and analysis of the factors affecting the complications.Methods:A retrospective analysis of 900 cases of lower urinary calculi in our hospital from January 2000 to October 2017 in our hospital were selected as research objects,The number of operations,the time of net operation,the time of operation,the time of hospitalization,the curative effect,the complications and the influencing factors of complications were observed by Logistic regression analysis.Results:Of the 990 cases,410 cases were excluded from 1 times of gravel,accounting for 45.55%;273 cases of 2 lithotripsy cases,accounting for 30.33%;161 cases of 3 lithotripsy cases,accounting for 17.88%.The operation time was 30~70min,the average(52.39+3.10)min.After 6 months of follow-up,519 cases(57.66%)were cured,325 cases were effective(36.11%),56 cases were invalid(6.22%),and the total effective rate was 93.77%(844/900)(P<0.05);Among 900 patients,658 cases had complications and 242 cases had no complications.There were significant differences between body weight index,stone length diameter,stone diameter,impact times and impact energy between the two groups(P<0.05);In the Logistic regression analysis of the influencing factors of postoperative complications of lower urinary calculi,stone length diameter,stone diameter,impact times and impact energy were all the complications after lower urinary calculi surgery(P<0.05).Conclusion:The clinical effect of extracorporeal shock wave lithotripsy in the treatment of lower urinary calculi is significant.The possible factors of postoperative complications are mainly the length of the stone,the diameter of the stone,the number of times of impact,the impact energy,the greater the number of shocks,the greater the probability of complications.In clinical application,the indications and operating procedures should be strictly controlled to avoid the occurrence of complications so as to achieve better clinical efficacy.