经皮肾镜取石术后并发症的相关风险因素分析

Risk factors of complications associated with percutaneous nephrolithotomy

目的分析经皮肾镜取石术后并发症的相关风险因素。方法回顾性分析2017年2月至2018年12月本院行经皮肾镜取石术的80例患者的临床资料,包括术前是否合并糖尿病、有无尿路感染、穿刺通道数目、血常规、肾结石Guy’s分级、肾结石S.T.O.N.E.评分、并发症发生情况、并发症Clavien-Dindo严重程度分级等,并且采用logistic回归分析,评估各临床变量与术后并发症的相对危险系数。结果本研究共有26例患者术后发生并发症,logistic回归分析发现术后并发症的发生与患者肾结石Guy’s分级(OR=0.014,95%CI:0~0.933,P=0.046)、肾结石S.T.O.N.E.评分(OR=5.397,95%CI:1.963~14.840,P=0.001)、糖尿病(OR=0.013,95%CI:0.001~0.153,P=0.001)、中性粒细胞淋巴细胞比值(NLR)(OR=0.233,95%CI:0.081~0.668,P=0.007)、尿路感染(OR=0.059,95%CI:0.005~0.658,P=0.021)有显著相关性,与年龄、性别、体重指数(BMI)、手术时间、穿刺通道数目无相关性(P>0.05)。结论肾结石Guy’s分级高、S.T.O.N.E.评分高、术前合并糖尿病、术前未控制的尿路感染、高NLR为经皮肾镜术后并发症发生的高危因素。

Objective To explore the risk factors of complications associated with percutane-ous nephrolithotomy(PCNL).Methods From February 2017 to December 2018,80 patients who un-derwent PCNL were retrospectively analyzed.The clinical data of all patients including preoperative dia-betes mellitus,urinary tract infection,number of puncture passages,blood routine,Guys grade of renal calculi,S.T.0.N.E.score of renal calculi,occurrence of complications and Clavien-Dindo severity grade of complications were analyzed by logistic regression,and the relative risk factors of clinical vari-ables and postoperative complications were evaluated.Results There were 26 patients with postopera-tive complications in this study.Logistic regression analysis showed that the incidence of postoperative complications and Guy s classification of renal calculi(OR:0.014,95%CI:0-0.933,95%CI:0-0.933,P=0.046),S.T.0.N.E.score(OR:5.397,95%CI:1.963-14.840,P=0.001),diabetes(OR:0.013,95%CI:0.001-0.153,P=0.001),NLR(OR:0.233,95%CI:0.081-0.668,P=0.007),urinary tract infection(OR:0.059,95%CI:0.005-0.658,P=0.021)had significant correla-tion.There was no correlation with age,sex,BMI,operation time and number of puncture channels.Conclusions High Guy's grade,high S.T.0.N.E.score,preoperative diabetes mellitus,uncontrolled urinary tract infection and high NLR are high risk factors for complications after PCNL.