tNPUAS联合一次性输尿管软镜一期治疗2.5～3.0cm非鹿角状肾结石术后发生SIRS相关危险因素分析
Analysis of risk factors related to SIRS after treatment of 2.5-3.0 cm non-staghorn kidney stones with tNPUAS combined with disposable ureteroscope
魏海洋 1时新宇 1许长宝 1李武学 1杨军凯 1张天贺 1黄志恒 1赵兴华1
作者信息
- 1. 郑州大学第二附属医院泌尿外科(郑州,450000)
- 折叠
摘要
目的:探究前段可弯负压吸引鞘(tip-flexible negative pressure ureteral access sheath,tNPUAS)联合一次性输尿管软镜一期治疗2.5～3.0 cm非鹿角状肾结石术后发生全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)的相关危险因素.方法:回顾性分析2022年1月-2023年9月在郑州大学第二附属医院泌尿外科行tNPUAS联合一次性输尿管软镜一期治疗2.5～3.0 cm非鹿角状肾结石患者的临床资料,采用单因素和多因素logistic回归分析筛选与tNPUAS联合一次性输尿管软镜一期治疗2.5～3.0 cm非鹿角状肾结石术后发生SIRS的危险因素,并绘制ROC曲线,评估预测效能.结果:纳入的205例患者中,19例(9.27％)术后发生 SIRS.多因素 logistic 回归分析显示,术前 NLR＞2.50(OR=2.953,95％CI:1.006～8.669,P=0.049)、AGR＜1.84(OR=0.055,95％CI:0.004～0.860,P=0.039)、结石平均 CT 值＜956.5 HU(OR=0.995,95％CI:0.992～0.998,P＜0.001)和手术时间＞95.7 min(OR=1.036,95％CI:1.012～1.060,P=0.003)是术后发生SIRS的独立危险因素.结论:NLR较高、AGR较低、结石平均CT值较小和手术时间较长是tNPUAS联合一次性输尿管软镜一期治疗2.5～3.0 cm非鹿角状肾结石术后SIRS的独立危险因素.术前NLR、ARG及结石平均CT值在预测术后SIRS的发生中具有一定的价值,同时,应严格控制手术时长以降低术后SIRS的发生.
Abstract
Objective:To explore the risk factors in systemic inflammatory response syndrome(SIRS)after the treatment of 2.5-3.0 cm non-staghorn kidney stones with tip-flexible negative pressure ureteral access sheath(tNPUAS)combined with disposable ureteroscope.Methods:The clinical data of patients with 2.5-3.0 cm non-staghorn kidney stones treated with tNPUAS combined with disposable ureteroscope in the Department of Urolo-gy.Second Affiliated Hospital of Zhengzhou University from January 2022 to September 2023 were retrospectively analyzed.Univariate and multivariate logistic regression analysis were used to screen the risk factors in SIRS after the treatment of 2.5-3.0 cm non-staghorn kidney stones with tNPUAS combined with disposable ureteroscope,and ROC curve was plotted to evaluate the predictive efficacy.Results:A total of 205 patients were included,and 19(9.27％)had SIRS after operation.Multivariate logistic regression analysis showed that preoperative NLR＞2.50(OR=2.953,95％CI:1.006-8.669,P=0.049),AGR＜1.84(OR=0.055,95％CI:0.004-0.860,P=0.039),the mean CT value of calculus＜956.5 HU(OR=0.995,95％CI:0.992-0.998,P＜0.001),and the operative time＞95.7 min(OR=1.036,95％CI:1.012-1.060,P=0.003)were independent risk factors in postoperative SIRS.Conclusion:Higher NLR,lower AGR,smaller mean CT value and longer operation time are independent risk factors in SIRS after treatment of 2.5-3.0 cm non-staghorn kidney stones with tNPUAS com-bined with one-stage disposable ureteroscope.Preoperative NLR,ARG and mean CT value of calculi have certain value in predicting the occurrence of postoperative SIRS.Meanwhile,the duration of operation should be strictly controlled to reduce the occurrence of postoperative SIRS.
关键词
前段可弯负压吸引鞘/一次性输尿管软镜/肾结石/全身炎症反应综合征Key words
tip-flexible negative pressure ureteral access sheath/disposable ureteroscope/kidney stones/sys-temic inflammatory response syndrome引用本文复制引用
出版年
2024
NETL
NSTL
万方数据