目的 探讨Ⅰ期经皮肾镜取石术( PCNL)术后结石残留的主要影响因素. 方法 回顾性分析776 例Ⅰ期PCNL患者围术期资料,其中Ⅰ期术后结石残留217例. 对可能影响PCNL后结石残留的相关因素进行单因素分析,将有统计学意义指标采用多因素logistic回归模型进行分析. 结果 多因素logistic回归分析结果显示,结石负荷、肾盂类型、肾功能不全及鹿角形肾结石是Ⅰ期PCNL术后结石残留的独立危险因素(P均 〈0.05). 结论 结石负荷〉1000 mm^2、分支型肾盂、鹿角形肾结石、肾功能不全均可增加Ⅰ期PCNL术后结石残留的风险. 术前改善患者肾功能,明确肾盂类型及结石负荷并采取个性化方案是降低Ⅰ期PCNL术后结石残留的重要措施.
Objective To explore the main influencing factors of residual calculi after single-session percutaneous nephrolithotomy ( PCNL) .Methods The perioperative clinical data of 776 patients who underwent single-session PCNL were retrospectively analyzed.And residual calculi were observed in 217 patients after single-session PCNL.The probable related influencing factors of residual calculi after single-session PCNL were assessed by univariate analysis, and the statistically significant factors were analyzed by multivariate logistic regression analysis.Results Multivariate logistic regression analysis showed that calculus load,type of renal pelvis,renal insufficiency and staghorn-shaped renal calculi were independent risk factors for residual calculi after single-session PCNL(all P〈0.05).Conclusion Calculus load more than 1000 mm^2 ,branched renal pelvis,staghorn-shaped renal calculi and renal insufficiency might increase the risk of residual calculi after single-session PCNL.The important management for reducing residual calculi after single-session PCNL includes the preoperative improvement of renal insufficiency and the application of individualized approach following confirming the type of renal pelvis and calculus load before operation.