Zhou Qi, Ouyang Jun, Zhang Zhi-Yu
Department of Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou, PR China.
SAGE Open Med. 2023 Aug 8;11:20503121231191995. doi: 10.1177/20503121231191995. eCollection 2023.
This study aimed to identify the risk factors for postoperative recurrence of unilateral upper ureteral calculi and develop a predictive nomogram. A retrospective analysis was conducted on 243 patients diagnosed with unilateral upper ureteral calculi who were treated at our hospital between January 1, 2016 and December 31, 2018. Patients were divided into two groups: recurrence or non-recurrence cohort. Differences in age, gender, smoking and/or drinking habit, laterality, stone diameter, ureteral stricture, stone incarceration, urinary tract infection, surgical intervention, operation time, body mass index, and metabolic syndrome were analyzed. Discrete risk factors were screened, and a nomogram was developed to predict the probability of stone recurrence. The study found that the recurrence of ureteral calculi was associated with factors including stone diameter, ureteral stricture, stone incarceration, surgical intervention, operation time, metabolic syndrome, body mass index, triglycerides, diabetes, and high blood pressure ( 0.05). Ureteral stricture, surgical intervention, metabolic syndrome, and triglycerides were found to be discrete risk factors for stone recurrence ( < 0.05). In addition, the study revealed that the stone recurrence rate of metabolic syndrome patients was significantly elevated ( < 0.05), as demonstrated by the survival curve. Lastly, using the nomogram, with an area under the curve value of 0.929, the recurrence rate of ureteral calculi was predicted. The study identified that preoperative ureteral stricture, laparoscopic ureterolithotomy, metabolic syndrome, and triglycerides are closely related to postoperative recurrence of ureteral calculi. The nomogram developed in this study can be used as a predictive tool for the recurrence rate of ureteral calculi.
本研究旨在确定单侧上尿路结石术后复发的危险因素并构建预测列线图。对2016年1月1日至2018年12月31日在我院接受治疗的243例诊断为单侧上尿路结石的患者进行回顾性分析。患者分为两组:复发组和未复发组。分析了年龄、性别、吸烟和/或饮酒习惯、结石侧别、结石直径、输尿管狭窄、结石嵌顿、尿路感染、手术干预、手术时间、体重指数和代谢综合征等方面的差异。筛选出离散危险因素,并构建列线图以预测结石复发的概率。研究发现,输尿管结石复发与结石直径、输尿管狭窄、结石嵌顿、手术干预、手术时间、代谢综合征、体重指数、甘油三酯、糖尿病和高血压等因素相关(P<0.05)。输尿管狭窄、手术干预、代谢综合征和甘油三酯被发现是结石复发的离散危险因素(P<0.05)。此外,生存曲线显示,代谢综合征患者的结石复发率显著升高(P<0.05)。最后,使用列线图预测输尿管结石复发率,曲线下面积值为0.929。该研究确定术前输尿管狭窄、腹腔镜输尿管切开取石术、代谢综合征和甘油三酯与输尿管结石术后复发密切相关。本研究构建的列线图可作为输尿管结石复发率的预测工具。