Wang Mingqing, Shi Qiduo, Wang Xuguang, Yang Kun, Yang Rui
Centre of Urology, Nankai Hospital, Tianjin, 300100, People's Republic of China.
Urol Res. 2011 Feb;39(1):51-7. doi: 10.1007/s00240-010-0274-5. Epub 2010 Apr 18.
The present study was designed to evaluate the clinical outcome of using extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteric calculi and to establish a predictive model for the stone-free rate in patients receiving the treatment. A total of 831 patients with ureteric calculi were accepted in this study. Several parameters, including stone site, stone number, stone size, history of urolithiasis, renal colic, hydronephrosis, and double-J ureteric stent, were analyzed using univariate and multivariate analyses. A prediction model was established based on the logistic regression analysis of the significant factors, and the goodness-of-fit of the model was evaluated by employing the Hosmer-Lemeshow test. At a 3-month follow-up after ESWL treatment, the overall stone-free rate was 96.8% (804/831) with no serious complications being found, while the treatment failed in 3.2% (27/831) of the patients. Five factors, including stone number, stone size, history of urolithiasis, renal colic, and double-J ureteric stent contributed significantly to the clinical outcome of the ESWL treatment. The prediction model had a sensitivity and overall accuracy of 99.8 and 96.9%, respectively. The results show that ESWL remains an effective method for treating ureteric calculi. The prediction model established in this study could be used as a method for estimating prognosis in patients following ESWL treatment.
本研究旨在评估体外冲击波碎石术(ESWL)治疗输尿管结石的临床疗效,并建立接受该治疗患者结石清除率的预测模型。本研究共纳入831例输尿管结石患者。使用单因素和多因素分析方法,对包括结石部位、结石数量、结石大小、尿路结石病史、肾绞痛、肾积水和双J输尿管支架等多个参数进行了分析。基于对显著因素的逻辑回归分析建立了预测模型,并采用Hosmer-Lemeshow检验评估模型的拟合优度。ESWL治疗后3个月随访时,总体结石清除率为96.8%(804/831),未发现严重并发症,而3.2%(27/831)的患者治疗失败。结石数量、结石大小、尿路结石病史、肾绞痛和双J输尿管支架这五个因素对ESWL治疗的临床疗效有显著影响。该预测模型的敏感度和总体准确率分别为99.8%和96.9%。结果表明,ESWL仍然是治疗输尿管结石的有效方法。本研究建立的预测模型可作为评估ESWL治疗后患者预后的一种方法。