输尿管结石合并息肉病人术后发生输尿管狭窄的危险因素分析

    Analysis of the risk factors of ureteral stricture in patients with ureteral calculi combined with polyps after surgery

    • 摘要:
      目的: 探讨输尿管结石合并息肉术后发生输尿管狭窄的危险因素。
      方法: 选择输尿管结石合并输尿管息肉病人107例为研究对象,所有病人均行经尿道输尿管硬镜/软镜碎石术,依据术后情况分为输尿管狭窄组(24例)与输尿管非狭窄组(83例)。统计分析2组病人的相关临床资料,采用单因素和多因素logistic回归分析输尿管结石合并输尿管息肉病人术后发生输尿管狭窄的相关风险因素。
      结果: 输尿管狭窄与非狭窄病人输尿管结石处管壁厚度、术前肾积水程度、结石直径、病程、手术时间的差异均有统计学意义(P < 0.01),而性别、年龄、结石位置、既往手术史的组间差异均无统计学意义(P > 0.05)。多因素logistic回归结果提示,病人结石处输尿管管壁增厚是发生输尿管狭窄的独立危险因素(OR = 58.545,P < 0.01)。
      结论: 结石处输尿管管壁增厚是输尿管结石合并息肉病人术后发生输尿管狭窄的独立危险因素。医务人员术前应充分考虑相关危险因素,有效干预,从而改善预后。

       

      Abstract:
      Objective To investigate the risk factors of postoperative ureteral stricture in patients with ureteral calcul combined with polyps.
      Methods A total of 107 patients with ureteral calculi combined with ureteral polyps treated in Anqing First's Hospital from January 2021 to August 2024 were included as research subjects. All patients were treated with transurethral ureteroscopy rigid/soft for stone fragmentation. According to the postoperative condition, the patients were divided into the ureteral stricture group (24 cases) and non-ureteral stricture group (83 cases). The general information and clinical data in two groups were counted and analyzed. The univariate multivariate logistic regression analyses were used to identify the risk factors related to postoperative ureteral stricture in patients with ureteral calculi combined with ureter polyps.
      Results There were statistically significant differences in the thickness of ureteral calculi wall, degree of preoperative hydronephrosis, diameter of the calculi, course of the disease and operation time between two groups (P < 0.01), while there was no statistical significance in the gender, age, calculi location and previous surgical history between two groups (P > 0.05). The results of multivariate logistic regression indicated that the thickening of the ureteral wall at the stone site was an independent risk factor of ureteral stricture (OR = 58.545, P < 0.01).
      Conclusions The thickening of the ureteral wall at the site of calculi is an independent risk factor of ureteral stricture in patients with ureteral calculi combined with polyps after surgery. Medical staff should fully consider the relevant risk factors and effectively intervene before surgery to improve prognosis.

       

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