经皮肾镜取石术在泌尿系结石治疗中的应用及术后复发的影响因素

The application of percutaneous nephrolithotomy in the treatment of urinary calculi and the influencing factors of recurrence

目的探讨经皮肾镜取石术(PCNL)在泌尿系结石治疗中的应用效果,并分析影响PCNL术后结石复发的危险因素。方法回顾性分析2020年1月至2021年1月本院收治的82例经PCNL治疗的泌尿系结石患者的临床资料。根据术后结石复发情况将患者分为复发组(17例)与未复发组(65例)。采用多因素logistic回归分析PCNL术后泌尿系结石复发的影响因素。结果82例患者的手术时间为(80.53±20.23)min,造瘘管留置时间为(3.01±1.57)d,住院时间为(12.53±1.27)d,结石清除率为90.24%(74/82);术后出现并发症15例(18.29%);随访2年,术后泌尿系结石复发率为20.73%(17/82);多因素logistic回归分析结果显示,存在内分泌疾病史、感染性结石、术前白细胞异常、结石清除率低是影响PCNL术后泌尿系结石复发的独立危险因素(均P<0.05)。结论PCNL对泌尿系结石的治疗效果较好,控制影响术后泌尿系结石复发的危险因素,可进一步提升泌尿系结石的治疗效果。

ObjectiveTo investigate the effect of percutaneous nephrolithotomy(PCNL)in the treatment of urinary calculi,and analyze the risk factors of stone recurrence after PCNL.MethodsThe clinical data of 82 patients with urinary calculi treated by PCNL from January 2020 to January 2021 in our hospital were retrospectively analyzed.According to the recurrence of postoperative stones,they were divided into recurrence group(17 cases)and non recurrence group(65 cases).Multivariate logistic regression analysis was used to analyze the influencing factors of recurrence of urinary calculi after PCNL.ResultsThe operation time of 82 patients was(80.53±20.23)min,the indwelling time of fistula was(3.01±1.57)d,the hospitalization time was(12.53±1.27)d,and the stone clearance rate was 90.24%(74/82).Postoperative complications occurred in 15 cases(18.29%).The recurrence rate was 20.73%(17/82)after 2 years of follow-up.Multivariate logistic regression analysis showed that the history of endocrine diseases,infectious stones,preoperative leukocyte abnormalities and low stone clearance rate were independent risk factors for recurrence of urinary calculi after PCNL(all P<0.05).ConclusionsThe PCNL demonstrates a favorable efficacy in the management of urinary calculi,and can further enhance treatment outcomes by effectively controlling the risk factors associated with postoperative recurrence of urinary calculi.