在输尿管软镜检查（flexible URS）前常规使用钙通道阻滞剂似乎有助于首次输尿管镜鞘（UAS）插入：一项单中心回顾性研究。

The regular use of calcium channel blockers before flexible URS appears to facilitate primary UAS insertion: a retrospective study in a single center.

作者信息

Xiang Yechen, Yan Tingshuai, Fu Maoling, Quan Keli, Shu Jianping, Wang Ruoyu

机构信息

Department of Urology, The First People's Hospital of Huaihua, University of South China, No. 144 Jinxi South Road, Huaihua, 418000, Hunan, China.

出版信息

Int Urol Nephrol. 2023 Mar;55(3):547-551. doi: 10.1007/s11255-022-03426-8. Epub 2022 Nov 30.

DOI:10.1007/s11255-022-03426-8

PMID:36450869

Abstract

PURPOSE

To evaluate the effect of regular use of CCB before flexible URS for successful primary UAS insertion.

MATERIALS AND METHODS

We retrospectively analyzed 209 patients who underwent flexible ureteroscopy (URS) for upper urinary tract calculi between Jan 2021 and Dec 2021. Patients were divided into two groups based on whether calcium channel blockers (CCB) were used (n = 72) or not (n = 137). The following parameters were collected: age, sex, height and weight, BMI, stone location, stone burden, number of stones, operation time, hospital stay, hospital readmission, post-operative fever, post-operative SIRS rate, Clavien-Dindo grade, hospitalization costs, successful primary UAS insertion. We compared the two groups using Student's t test, Mann-Whitney U test and χ test for quantitative and categorical variables, respectively. A logistic regression model was used to identify predictive factors of UAS successful primary insertion.

RESULTS

Compared with the non-CCB group, the CCB group had a higher successful primary UAS insertion rate (97.2% vs.85.4%, p = 0.008), and a lower hospital readmission rate (2.8% vs.12.4%, p = 0.021). In multivariate analyses, the regular use of CCB was the only predictive factor of successful primary UAS insertion rate (OR 6.32, 95% CI 1.41-28.29, p = 0.016).

CONCLUSION

The regular use of calcium channel blockers (CCB) before flexible URS appears to facilitate ureteral access sheaths (UAS) primary insertion.

摘要

目的

评估在软性输尿管镜检查（URS）前常规使用钙通道阻滞剂（CCB）对首次成功插入输尿管通路鞘（UAS）的效果。

材料与方法

我们回顾性分析了2021年1月至2021年12月期间因上尿路结石接受软性输尿管镜检查（URS）的209例患者。根据是否使用钙通道阻滞剂（CCB）将患者分为两组，使用CCB组（n = 72）和未使用CCB组（n = 137）。收集以下参数：年龄、性别、身高和体重、体重指数（BMI）、结石位置、结石负荷、结石数量、手术时间、住院时间、再次入院情况、术后发热、术后全身炎症反应综合征（SIRS）发生率、Clavien-Dindo分级、住院费用、首次成功插入UAS情况。我们分别使用学生t检验、曼-惠特尼U检验和χ检验对定量和分类变量进行两组间比较。使用逻辑回归模型确定UAS首次成功插入的预测因素。

结果

与未使用CCB组相比，使用CCB组首次成功插入UAS的比例更高（97.2%对85.4%，p = 0.008），再次入院率更低（2.8%对12.4%，p = 0.021）。在多因素分析中，常规使用CCB是首次成功插入UAS比例的唯一预测因素（比值比[OR] 6.32，95%置信区间[CI] 1.41 - 28.29，p = 0.016）。