输尿管结石冲击波碎石时间对无石率的影响

Effect of time to shock wave lithotripsy in ureteral stones on stone-free rate

目的通过比较输尿管结石不同时间段冲击波碎石术(SWL)后的无石率(SFR),确定碎石的最佳时间。方法回顾性分析590例输尿管结石患者在门诊行SWL时的诊治资料,根据出现症状至碎石时间分为早期组(0~7 d)、中期组(8~30 d)和晚期组(>30 d),通过logistic回归分析确定影响碎石后无石状态的因素。结果早期组与中期组SFR明显高于晚期组,差异有统计学意义(P<0.05)。在多因素logistic回归分析中,与SWL后无石状态独立相关的因素有年龄(OR=0.857,95%CI:0.836~0.889,P<0.05)、>30 d SWL(OR=0.337,95%CI:0.181~0.591,P<0.05)。结论输尿管结石SWL时间虽然与碎石后无石状态独立相关,但7 d内碎石不能提高SFR,而超过30 d碎石,SFR可能降低。

Objective To determine the optimal time for lithotripsy by comparing the stone-free rate(SFR)after shock wave lithotripsy(SWL)for ureteral stones in different time periods. Methods A retrospective analysis was performed on the diagnosis and treatment data of 590 patients with ureteral stones undergoing SWL in outpatient department,and they were divided into early group(0-7 d),intermediate group(8-30 d)and late group(>30 d)according to the time from symptom onset to lithotripsy.Logistic regression analysis was used to determine the factors that affect the stone-free state after lithotripsy. Results The SFR in the early group and intermediate group was significantly higher than that in the late group,and the difference was statistically significant(P<0.05).In multivariate logistic regression analysis,the factors independently associated with stone-free state after SWL were age(OR=0.857,95%CI:0.836-0.889,P<0.05)and>30 d SWL(OR=0.337,95%CI:0.181-0.591,P<0.05). Conclusion Although the time of SWL for ureteral stones is independently related to the stone-free state after lithotripsy,SFR cannot be increased within 7 d after lithotripsy,while SFR may be decreased after lithotripsy over 30 d.