上尿路结石碎石术中置入聚氨酯输尿管支架发生结壳的可能性因素研究

Study on possible factors of ureteral stents crusting after upper urinary tract lithotripsy

目的探讨上尿路结石术中置入聚氨酯输尿管支架管发生结壳的可能因素。方法收集从2016年9月—2020年3月在上海市静安区中心医院行上尿路结石手术的56例患者的临床和随访资料,均置入聚氨酯输尿管支架。所有尿路结石病例输尿管支架置管时间均不超过6周,根据是否产生输尿管支架管结壳将患者分为结壳组(34例)和无结壳组(22例)。采用卡方、Fisher精确概率检验和假设检验统计分析方法鉴别两组中影响结壳产生的可能风险因素。结果经对相关临床指标进行统计分析,发现支架管留置时间长、24 h尿钙值高、支架有细菌定植的患者更容易发生支架管结壳,差异有统计学意义(P<0.05);两组患者的年龄、性别差异无统计学意义。结论支架管留置时间延长、尿钙值增高和支架管细菌定植是促使支架管易于产生结壳的可能因素。

Objective To investigate the possible factors of the ureteral stents crusting after upper urinary tract lithotripsy.Methods The clinical and follow-up data of 56 patients,who underwent upper urinary lithotripsy and was implanted polyurethane ureteral stent in our hospital from September 2016 to March 2020,were collected.All cases had the indwelling time of no more than 6 weeks and were divided into crust group(n=34) and crustless group(n=22),according to whether the ureteral stents crusted or not.Statistical analysis methods including chi-square test,Fisher exact test and hypothesis testing were used to identify the possible factors affecting the encrustation in the two groups.Results After statistical analysis of the relevant clinical data,it was found that the encrustation on the ureteral stents was more likely to occur in the patients with longer indwelling time,the higher 24-hour urinary calcium levels and the presence of bacterial colonization on the ureteral stents(P<0.05);There was no significant difference in age and sex between the two groups.Conclusion Prolonged indwelling time,increased urinary calcium levels and bacterial colonization of the ureteral stents may be the factors prompting the encrustation on the ureteral stents easily.