Meng Rui, Lv Xiaoyong, Wang Jiandong, Han Yu, Zhai Zhipeng
Department of Urology, YuQuan Hospital, Tsinghua University, Beijing, China.
Department of Urology, Peking University First Hospital - Miyun Hospital, Beijing, China.
Medicine (Baltimore). 2025 Sep 12;104(37):e44191. doi: 10.1097/MD.0000000000044191.
This study explores the risk factors for residual stones and stone recurrence after extracorporeal shock wave lithotripsy (ESWL), aiming to assist in clinical practice to improve the stone clearance rate, reduce the stone recurrence rate, and enhance the surgical outcomes. A retrospective analysis was conducted on 367 patients with ureteral stone who underwent ESWL from February 2022 to February 2025. Among them, 328 patients had complete data. General clinical data, stone characteristics, and follow-up data of the patients were collected. Univariate and multivariate logistic regression analyses were performed on the risk factors for residual stones and stone recurrence after ESWL. In this study, the stone clearance rate after ESWL was 85.37% (280/328), and the stone recurrence rate within 3 months after the operation was 20.36% (57/280). Univariate logistic regression analysis found that body mass index (P = .048), stone size (P < .001), stone density (P = .020), and preoperative serum creatinine (P = .045) were risk factors for residual stones after ESWL. Gender (P = .038), coronary heart disease (CHD, P = .024), and stone density (P = .037) were risk factors for stone recurrence after ESWL. Multivariate logistic regression analysis revealed that stone size (P < .001), stone hardness (P = .036), and preoperative serum creatinine (P = .008) were independent risk factors for residual stones after ESWL. CHD (P = .046) and stone density (P = .046) were independent risk factors for stone recurrence after ESWL. ESWL for ureteral stone has a relatively high stone clearance rate and stone recurrence rate. body mass index, stone size, stone density, and preoperative serum creatinine are independent risk factors for residual stones after ESWL. CHD and stone density are independent risk factors for stone recurrence after ESWL.
本研究探讨体外冲击波碎石术（ESWL）后残留结石及结石复发的危险因素，旨在辅助临床实践提高结石清除率、降低结石复发率并改善手术效果。对2022年2月至2025年2月期间接受ESWL的367例输尿管结石患者进行回顾性分析。其中，328例患者有完整数据。收集患者的一般临床资料、结石特征及随访数据。对ESWL后残留结石及结石复发的危险因素进行单因素和多因素logistic回归分析。本研究中，ESWL后的结石清除率为85.37%（280/328），术后3个月内的结石复发率为20.36%（57/280）。单因素logistic回归分析发现，体重指数（P = 0.048）、结石大小（P < 0.001）、结石密度（P = 0.020）及术前血清肌酐（P = 0.045）是ESWL后残留结石的危险因素。性别（P = 0.038）、冠心病（CHD，P = 0.024）及结石密度（P = 0.037）是ESWL后结石复发的危险因素。多因素logistic回归分析显示，结石大小（P < 0.001）、结石硬度（P = 0.036）及术前血清肌酐（P = 0.008）是ESWL后残留结石的独立危险因素。CHD（P = 0.046）及结石密度（P = 0.046）是ESWL后结石复发的独立危险因素。输尿管结石ESWL的结石清除率和结石复发率相对较高。体重指数、结石大小、结石密度及术前血清肌酐是ESWL后残留结石的独立危险因素。CHD和结石密度是ESWL后结石复发的独立危险因素。
