输尿管结石患者行输尿管镜下钬激光碎石术治疗后输尿管狭窄发生情况及影响因素分析

Analysis of the Occurrence and Influencing Factors of Ureteral Stricture in Ureteral Calculi Patients after Ureteroscopic Holmium Laser Lithotripsy

目的:分析输尿管结石患者行输尿管镜下钬激光碎石术治疗后输尿管狭窄发生情况及影响因素。方法:选择2022年2月—2023年2月贵阳贵航医院收治的329例行输尿管镜下钬激光碎石术治疗的输尿管结石患者作为研究对象。观察治疗后输尿管狭窄发生情况,分为狭窄组(n=21)、非狭窄组(n=308),比较两组一般资料,分析输尿管结石患者行输尿管镜下钬激光碎石术治疗后输尿管狭窄发生的影响因素。结果:329例行输尿管镜下钬激光碎石术治疗的输尿管结石患者中,21例治疗后发生输尿管狭窄,输尿管狭窄发生率为6.38%。两组性别、年龄、体重指数、结石部位、患侧、合并尿路感染、结石残余、双J管留置时间比较,差异无统计学意义(P>0.05);两组病程、结石直径、肾积水严重、结石嵌顿、炎性黏膜包裹比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,病程长、结石直径大、肾积水严重、结石嵌顿、炎性黏膜包裹为输尿管镜下钬激光碎石术治疗后输尿管狭窄发生的影响因素(P<0.05)。结论:输尿管镜下钬激光碎石术治疗后仍存在一定的输尿管狭窄发生风险,病程长、结石直径大、肾积水严重、结石嵌顿、炎性黏膜包裹为其影响因素。

Objective:To analyze the occurrence and influencing factors of ureteral stricture in ureteral calculi patients treated by ureteroscopic holmium laser lithotripsy.Method:A total of 329 patients with ureteral calculi who underwent ureteroscopic holmium laser lithotripsy treatment in Guiyang Guihang Hospital from February 2022 to February 2023 were selected as the study objects.The incidence of ureteral stricture after treatment was observed and divided into the stenosis group(n=21)and the non-stenosis group(n=308).The general data of the two groups were compared to analyze the influencing factors the occurrence of ureteral stricture in patients with ureteral calculi treated by ureteroscopic holmium laser lithotripsis.Result:Among 329 patients with ureteral calculi treated by ureteroscopic holmium laser lithotripsy,a total of 21 cases developed ureteral stricture after treatment,and the incidence of ureteral stricture was 6.38%.There were no significant differences in gender,age,body mass index,stone site,affected side,combined urinary tract infection,stone residue,and indindment time of double J-tube between the two groups(P>0.05).There were statistically significant differences in the course of disease,stone diameter,severe hydronephrosis,stone incarceration and inflammatory mucosal encapsulation between the two groups(P<0.05).logistic regression analysis showed that long course of disease,large stone diameter,severe hydronephrosis, stone incarceration,and inflammatory mucosal encapsulation were the influencing factors of ureteral stricture after ureteroscopic holmium laser lithotripsy(P<0.05).Conclusion:Ureteroscopic holmium laser lithotripsy has a certain risk of ureteral stricture,and the influencing factors are long course of disease,large stone diameter,severe hydronephrosis,stone incarceration,and inflammatory mucosal encapsulation.