The clinical efficacy analysis of One-stage flexible ureteroscopic lithotripsy assisted by CT urography and intelligent pressure control platform and the establishment of a prediction model for stone clearance rate.

To explore the clinical efficacy of the first-stage flexible ureteroscope lithotripsy assisted by CT urography (CTU) combined with an intelligent pressure control platform, and to establish a clinical prediction model after analyzing the influencing factors of the stone-free rate (SFR). The clinical data of patients who underwent the first-stage flexible ureteroscope lithotripsy assisted by preoperative CTU combined with intraoperative intelligent pressure control platform in our hospital from January 2019 to September 2024 were retrospectively analyzed. The stone-free rate was taken as the main indicator for evaluating the clinical efficacy. Logistic regression analysis was performed to identify the independent risk factors affecting the clinical efficacy and to establish a clinical prediction model for the stone-free rate. A total of 368 patients in our hospital underwent the first-stage flexible ureteroscope lithotripsy assisted by preoperative CTU combined with intraoperative intelligent pressure control platform, and all of them successfully completed the first-stage flexible ureteroscope lithotripsy. The SFR was 93% one month after the operation and 96.2% three months after the operation. After identifying the independent risk factors through Logistic regression analysis, the clinical prediction model for the SFR was established as follows: L = ureteral stricture + 1.288/1.144 × urinary tract infection + 1.315/1.144 × CT value of the stone + 1.154/1.144 × IPA angle + 4.989/1.144 × stone volume + 1.237/1.144 × stone composition. The areas under the ROC curve were as follows: combined predictor (0.913) > stone volume (0.895) > stone composition (0.639) > IPA angle (0.627) > ureteral stricture (0.609) > urinary tract infection (0.595). The first-stage flexible ureteroscope lithotripsy assisted by CTU combined with an intelligent pressure control platform for the treatment of patients with upper urinary tract stones is a surgical mode worthy of clinical promotion and reference. Using this prediction model to score the preoperative stone-free rate, when the score is > 20.61, it indicates that there may be residual stones after the operation.