肾结石患者输尿管软镜碎石术后发生肾周血肿的影响因素分析

Analysis of influencing factors of perirenal hematoma in patients with renal calculi after flexible ureteroscopy lithotripsy

目的:分析肾结石患者输尿管软镜碎石术后发生肾周血肿的影响因素。方法:回顾性分析2018年6月至2020年12月在该院行输尿管软镜下钬激光碎石术治疗的86例肾结石患者的临床资料,统计患者术后肾周血肿发生情况,将患者分为发生组、未发生组,比较两组患者的临床资料,并对术后发生肾周血肿的相关因素进行Logistic回归分析。结果:86例肾结石患者输尿管软镜碎石术后发生肾周血肿43例(50.00%),未发生肾周血肿43例(50.00%)。两组性别、年龄、结石位置、病程、有无糖尿病、体质量指数比较,差异均无统计学意义(P>0.05);发生组患者结石直径>10 mm、术前中重度肾积水、双J管留置时间>4周占比均高于未发生组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,结石直径>10 mm、术前中重度肾积水、双J管留置时间>4周是肾结石患者输尿管软镜碎石术后发生肾周血肿的独立危险因素(OR>1,P<0.05)。结论:结石直径>10 mm、术前中重度肾积水、双J管留置时间>4周是肾结石患者输尿管软镜碎石术后发生肾周血肿的独立危险因素,临床可针对以上因素制订预防措施,以降低术后肾周血肿发生率。

Objective:To analyze influencing factors of perirenal hematoma in patients with renal calculi after flexible ureteroscopy lithotripsy.Methods:The clinical data of 86 patients with renal calculi who underwent flexible ureteroscopy holmium laser lithotripsy in this hospital from June 2018 to December 2020 were retrospectively analyzed.The incidence of postoperative perirenal hematoma was statistically analyzed.These patients were divided into occurrence group and non-occurrence group.The clinical data of the two groups were compared.Logistic regression analysis was performed on the related factors of postoperative perirenal hematoma.Results:Perirenal hematoma occurred in 43 cases(50.00%)and no hematoma occurred in 43 cases(50.00%)in the 86 patients with renal calculi after flexible ureteroscopy.There were no significant differences in gender,age,stone location,course of disease,diabetes and Body mass index between the two groups(P>0.05).The proportions of stone diameter>10 mm,preoperative moderate to severe hydronephrosis and double J tube indwelling time>4 weeks in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that stone diameter>10 mm,preoperative moderate to severe hydronephrosis,double J tube indwelling time>4 weeks were independent risk factors for perirenal hematoma in the patients with renal calculi after flexible ureteroscopy(OR>1,P<0.05).Conclusions:The stone diameter>10 mm,preoperative moderate to severe hydronephrosis,double J tube indwelling time>4 weeks are the independent risk factors for perirenal hematoma in the patients with renal calculi after flexible ureteroscopy.Therefore,the targeted preventive measures can be formulated for the above factors to reduce the incidence of postoperative perirenal hematoma clinically.