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体重指数是否会影响超声引导下经皮肾镜取石术的结果?

Does Body Mass Index Impact the Outcomes of Ultrasound-Guided Percutaneous Nephrolithotomy?

作者信息

Jin Wei, Song Yan, Fei Xiang

机构信息

Division of Urology, Sheng Jing Hospital, China Medical University, Shenyang, China.

Division of Urology, Sheng Jing Hospital, China Medical University, Shenyang, China,

出版信息

Urol Int. 2019;103(2):149-155. doi: 10.1159/000501809. Epub 2019 Jul 16.

Abstract

BACKGROUND AND PURPOSE

To evaluate whether body mass index (BMI) has an impact on the outcomes of ultrasound-guided percutaneous nephrolithotomy (PCNL).

MATERIALS AND METHODS

The data of 359 patients who required PCNL at ShengJing hospital between June 2013 and July 2015 were reviewed, with the patients divided into 4 groups based on different ranges of BMI: <25, 25-29.9, 30-34.9, and ≥35 kg/m2. Baseline characteristics and outcomes were compared between the groups. Multivariable logistic regressions were used to evaluate the independent contribution of BMI as a predictor of outcomes. The Modified Clavien classification system was used for reporting complications. Results were compared between the groups using the chi-square and multivariate logistic regression tests.

RESULTS

No significant differences were noted in the demographic data between the 4 groups. Ultrasound screening time, total operative time, and hospital stay all increased with increasing BMI. No difference was found in the complication rate, stone free rate, or need for auxiliary procedures.

CONCLUSION

Obesity does not increase the incidence of complications in ultrasound-guided PCNL, and the efficacy of the technique for obese patients is similar to that for normal weight patients. The lateral decubitus position was preferred in patients with higher BMI.

摘要

背景与目的

评估体重指数(BMI)是否对超声引导下经皮肾镜取石术(PCNL)的手术结果产生影响。

材料与方法

回顾了2013年6月至2015年7月在盛京医院接受PCNL治疗的359例患者的数据,根据BMI的不同范围将患者分为4组:<25、25 - 29.9、30 - 34.9和≥35kg/m²。比较各组的基线特征和手术结果。采用多变量逻辑回归分析评估BMI作为手术结果预测指标的独立作用。采用改良Clavien分类系统报告并发症。使用卡方检验和多变量逻辑回归检验比较各组结果。

结果

4组患者的人口统计学数据无显著差异。超声筛查时间、总手术时间和住院时间均随BMI的增加而延长。并发症发生率、结石清除率或辅助手术需求方面未发现差异。

结论

肥胖并未增加超声引导下PCNL的并发症发生率,该技术对肥胖患者的疗效与正常体重患者相似。BMI较高的患者首选侧卧位。

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