超声引导下同轴导丝法更换肾盂造瘘管失败危险因素分析

Risk factors of failure in replacement of pyelostomy tube with coaxial guide wire under ultrasound guidance

目的:探讨长期留置肾盂造瘘管患者超声引导下同轴导丝法换管失败的危险因素。方法:回顾性分析超声引导下同轴导丝法更换肾盂造瘘管换管患者的临床资料,对比分析换管成功组与换管失败组的相关指标;采用多因素Logistic回归模型筛选影响超声引导下同轴导丝法换管失败的独立危险因素。结果:换管间隔时间、造瘘口周围皮肤感染及体重指数(BMI)在两组间比较具有统计学差异(P<0.05),多因素Logistic回归分析结果显示换管间隔时间≥90 d(OR=8.809,95%CI:2.270~34.188)、BMI≥24.0 kg/m^(2)(OR=5.091,95%CI:1.531~22.744)是导致换管失败的危险因素。结论:换管间隔时间≥90 d、BMI≥24.0 kg/m^(2)是导致同轴导丝法更换肾盂造瘘管失败的危险因素,对此类患者应慎用同轴导丝法换管。

Objective:To investigate the risk factors of failure in replacement of pyelostomy tube with coaxial guide wire under ultrasound guidance.Methods:The clinical data of patients who underwent ultrasound guided coaxial guide wire replacement of pyelostomy tube were analyzed retrospectively.Multivariate Logistic regression analyses was used to screen the independent risk factors affecting the failure of ultrasonic guided coaxial guide wire tube replacement.Results:There were significant differences between the two groups in tube change interval,skin infection around the stoma and BMI.Multivariate Logistic regression analysis showed that tube change interval≥90 days(OR=8.809,95%CI:2.270 to 34.188),BMI≥24.0 kg/m^(2)(OR=5.091,95%CI:1.531 to 22.744)were independent risk factors for tube change failure.Conclusion:The interval between tube replacement≥90 days and BMI≥24.0 kg/m^(2) are the independent risk factors for failure in replacing renal pelvic fistula with coaxial guide wire method.The coaxial guide wire method shall be caution for such patients.