Chaohua Deng, Yu Zhang, Zhishen Li, Yan He, Xuebing Ma, Leming Song, Xianxin Zhu, Xiaodong Hu
Department of Urology II, Chuxiong Prefectural People's Hospital, Chuxiong, Yunnan, 675000, China.
Department of Urology, Ganzhou Branch of Southern Hospital, Ganzhou City, Ganzhou, 341000, Jiangxi Province, Jiangxi, China.
Urolithiasis. 2025 Jun 4;53(1):106. doi: 10.1007/s00240-025-01778-1.
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.
探讨CT尿路造影（CTU）联合智能压力控制平台辅助一期软性输尿管镜碎石术的临床疗效，并分析无石率（SFR）的影响因素后建立临床预测模型。回顾性分析2019年1月至2024年9月在我院接受术前CTU联合术中智能压力控制平台辅助一期软性输尿管镜碎石术患者的临床资料。将无石率作为评估临床疗效的主要指标。进行Logistic回归分析以确定影响临床疗效的独立危险因素，并建立无石率的临床预测模型。我院共有368例患者接受了术前CTU联合术中智能压力控制平台辅助的一期软性输尿管镜碎石术，且均成功完成一期软性输尿管镜碎石术。术后1个月SFR为93%，术后3个月为96.2%。通过Logistic回归分析确定独立危险因素后，建立的SFR临床预测模型如下：L = 输尿管狭窄 + 1.288/1.144×尿路感染 + 1.315/1.144×结石CT值 + 1.154/1.144×IPA角 + 4.989/1.144×结石体积 + 1.237/1.144×结石成分。ROC曲线下面积如下：联合预测指标（0.913）＞结石体积（0.895）＞结石成分（0.639）＞IPA角（0.627）＞输尿管狭窄（0.609）＞尿路感染（0.595）。CTU联合智能压力控制平台辅助一期软性输尿管镜碎石术治疗上尿路结石患者是一种值得临床推广和借鉴的手术方式。使用该预测模型对术前无石率进行评分，当评分＞20.61时，提示术后可能有残余结石。
