不同体位经皮肾镜取石术治疗肾结石的效果及其并发症危险因素分析

Effect of Percutaneous Nephrolithotomy in Different Positions on Renal Calculi and Analysis of Risk Factors of Complications

目的探讨不同体位经皮肾镜取石术(PCNL)治疗肾结石的效果及并发症危险因素分析。方法选择2021年8月至2022年8月驻马店市第一人民医院收治的98例接受PCNL治疗肾结石患者,根据入院顺序分为观察组、对照组,各49例。对照组接受俯卧位PCNL治疗,观察组接受改良Valdivia体位PCNL治疗。比较两组临床疗效及并发症发生情况。根据术后是否发生并发症将患者分为发生组、未发生组,采用单因素分析、多因素logistic回归分析PCNL术后并发症的影响因素。结果观察组结石清除率高于对照组,而术后并发症总发生率低于对照组(P<0.05)。多因素logistic回归分析显示,糖尿病、肾功能不全、鹿角形结石、手术时间、俯卧位PCNL为PCNL术后发生并发症的独立危险因素(P<0.05)。结论改良Valdivia体位下行PCNL治疗肾结石的效果更好,糖尿病、肾功能不全、鹿角形结石、手术时间、俯卧位PCNL等为术后并发症的危险因素。

Objective To investigate the curative effect of percutaneous nephrolithotomy(PCNL)in different positions in the treatment of renal calculi and its complication risk factors.Methods A total of 98 patients with PCNL treated in the First People’s Hospital of Zhumadian from August 2021 to August 2022 were selected and divided into observation group and control group according to the order of admission,with 49 cases in each group.The control group was treated with PCNL in prone position,and the observation group was treated with PCNL in modified Valdivia position.The clinical efficacy and complications of the two groups were compared.According to the occurrence of postoperative complications,the patients were divided into occurrence group and non-occurrence group.Univariate analysis and multivariate logistic regression were used to analyze the influencing factors of postoperative complications of PCNL.Results The calculus clearance rate of observation group was higher than that of control group,but the total incidence of postoperative complications was lower than that of control group(P<0.05).Multivariate logistic regression analysis showed that diabetes,renal insufficiency,antler calculus,operation time and prone position were independent risk factors for postoperative complications of PCNL(P<0.05).Conclusion PCNL under modified Valdivia position has better effect on the treatment of renal calculi.Diabetes,renal insufficiency,antler calculi,operation time and prone position PCNL are risk factors for postoperative complications.