输尿管镜钬激光碎石术后留置双J管并发症危险因素分析

摘要

Objective To study and investigate the risk factors of the complications of double-J ureteral stent indwelling after ureteroscopic holmium-laser lithotripsy. Methods Clinical data of 153 patients treated with ureteroscopic holmium-laser lithotripsy and indwelled double-J stent in Jiulongpo First People′s Hospital from Nov. 2010 to Feb. 2013 was retrospectively analyzed to identify the risk factors of the complications of double-J ureteral stent indwelling by Logistic regression method. Results Among all the 153 cases,compli-cations of double-J ureteral stent occurred in 106 patients(69. 3%). Results of multifactor analysis indicated that the risk factors of recurrent hematuria were the length of double-J ureteral stent≥26 cm,stent duration≥4 w and daily water intake≤1200 mL. Bladder irritation was associated with length of double-J ureteral stent≥26 cm,daily water intake≤1200 mL and none-drug intervention. Risk factors linked with ectopic double-J ureteral stent included length of double-J ureteral stent<26 cm and stent duration≥4 w. Additionally,length of double-J ureteral stent≥26 cm contributed to lumbago. Conclusion The improper selection of the length of double-J ureteral stent is the biggest risk factor of complications after ureteroscopic holmium-laser lithotrip-sy. Long duration of stent indwelling,subimbibition and none-drug intervention are also important risk factors of complications.%目的：研究分析输尿管镜钬激光碎石术后留置双J管并发症的危险因素。方法选择2010年11月至2013年2月于重庆市九龙坡区第一人民医院泌尿外科进行输尿管镜钬激光碎石术，并在术后留置双J管的患者153例，对其临床资料进行回顾性分析，对可能导致留置双J管后发生并发症的危险因素进行Logistic回归分析。结果153例患者留置双J管后发生并发症106例，发生率为69.3%。多危险因素回归分析表明，反复血尿的危险因素为双J管长度≥26 cm、留置时间≥4周和每日饮水量≤1200 mL；膀胱刺激征的危险因素为双J管长度≥26 cm、每日饮水量≤1200 mL和未有药物干预；双J管异位的危险因素为双J管长度<26 cm和留置时间≥4周；腰痛的危险因素为双J管长度≥26 cm。结论双J管长度选择不当是最大的危险因素，而双J管留置时间过久、患者饮水不足、未有药物干预也是并发症的重要危险因素。