Urology Surgery, Baoji City People's Hospital, Baoji 721000, Shannxi Province, China.
J Healthc Eng. 2022 Mar 8;2022:4733329. doi: 10.1155/2022/4733329. eCollection 2022.
To investigate the efficacy of super-mini-PCNL (SMP) and ureteroscopy in kidney stone (KS) sufferers and learn the risk factors of postoperative infection. A retrospective analysis was performed on 180 KS sufferers who were diagnosed and treated in our hospital from May 2019 to May 2021. They were enrolled into an observation group (OG, = 104) and a control group (CG, = 76) based on different treatment methods. Therein, the former was treated with SMP, while the latter was treated with ureteroscopy. The operation time, blood loss, hospital stay, recent stone-free rate (one week after operation), changes of serum creatinine (SCr), blood urea nitrogen (BUN), and cystatin C (CysC) levels before and after operation and complications were compared. Those sufferers were assigned to infected and uninfected groups based on their postoperative infection. The risk factors were assessed through logistic regression, and the model formula was established. The predictive value of this model for infection was tested through RO. Compared with CG, the operation time of the OG was longer, the blood loss and hospital stay were lower ( < 0.05), and the stone-free rate was higher ( < 0.05). Renal function indexes before and after treatment ( > 0.05) and postoperative complications revealed no significant difference ( > 0.05). Logistic regression analysis manifested that preoperative urinary tract infection (OR: 4.690, 95% CI: 1.170-18.802), preoperative blood glucose level (OR: 11.188, 95% CI: 2.106-59.442), positive urine culture (OR: 10.931, 95% CI: 2.453-48.705), and infectious stones (OR: 3.951, 95% CI: 1.020-15.300) were independently related to infection. The risk prediction equation is logit()=-8.913+1.545 × 1+2.415 × 2+2.392 × 3+1.374 × 4, with a goodness-of-fit value of 0.545. The AUC is 0.930, so SMP is superior to ureteroscopy in KS sufferers. Preoperative urinary tract infection, preoperative blood glucose level, positive urine culture, and infectious stones are independently related to infection.
探讨超微经皮肾镜取石术(SMP)与输尿管镜碎石术治疗肾结石(KS)患者的疗效,并分析术后感染的危险因素。方法:回顾性分析 2019 年 5 月至 2021 年 5 月我院收治的 180 例 KS 患者的临床资料,根据治疗方法的不同分为观察组(OG,n=104)和对照组(CG,n=76)。OG 患者采用 SMP 治疗,CG 患者采用输尿管镜碎石术治疗。比较两组患者的手术时间、术中出血量、住院时间、术后 1 周结石清除率、术前及术后血清肌酐(SCr)、血尿素氮(BUN)、胱抑素 C(CysC)水平以及并发症发生情况。根据术后感染情况将患者分为感染组和未感染组,采用 Logistic 回归分析术后感染的危险因素,并建立模型公式。采用受试者工作特征(ROC)曲线检验该模型对感染的预测价值。结果:与 CG 相比,OG 患者的手术时间更长,术中出血量和住院时间更少(P<0.05),术后 1 周结石清除率更高(P<0.05);两组患者治疗前后的肾功能指标(P>0.05)及术后并发症比较差异均无统计学意义(P>0.05)。Logistic 回归分析显示,术前尿路感染(OR:4.690,95%CI:1.17018.802)、术前血糖水平(OR:11.188,95%CI:2.10659.442)、阳性尿液培养(OR:10.931,95%CI:2.45348.705)和感染性结石(OR:3.951,95%CI:1.02015.300)是感染的独立危险因素。风险预测方程为 logit()=-8.913+1.545×1+2.415×2+2.392×3+1.374×4,拟合优度值为 0.545。ROC 曲线下面积(AUC)为 0.930,提示 SMP 治疗 KS 患者的效果优于输尿管镜碎石术。术前尿路感染、术前血糖水平、阳性尿液培养和感染性结石是感染的独立危险因素。