摘要
目的探讨输尿管软镜碎石术(FURL)对≥80岁上尿路结石患者的疗效及安全性评估。方法回顾性分析北京医院2019年1月至2023年9月因单侧上尿路结石行FURL治疗的297例老年患者临床资料,将患者分为高龄组(≥80岁)与中低龄组(60岁≤年龄<80岁),并采用倾向评分匹配(PSM)对患者术前临床资料进行匹配,比较两组患者的基线、围手术期及术后资料。结果PSM后共纳入患者116例,两组各58例。高龄组年龄[M(Q_(1),Q_(3))]为83.0(81.0,86.0)岁,男29例;中低龄组年龄为69.5(64.8,74.0)岁,男33例。高龄组术后住院时长[M(Q_(1),Q_(3))]大于中低龄组[2(1,3)比1(1,2)d,P=0.002]。高龄组、中低龄组术后分别有3例、1例患者发生严重并发症,均无需外科干预;结石清除率(SFR)[79.3%(46/58)比84.5%(49/58)]、手术时间[M(Q_(1),Q_(3)),70.0(48.3,100.0)比65.0(46.5,101.2)min]与术后并发症发生率[25.9%(15/58)比22.4%(13/58)]差异均无统计学意义(均P>0.05)。结论FURL治疗≥80岁上尿路结石患者的SFR、手术时间、术后并发症发生率与中低龄老年患者相当,具有较好的安全性和有效性。
Objective To assess the efficacy and safety of flexible ureteral lithotripsy(FURL)for treating upper urinary tract calculi in patients≥80 years.Methods This study retrospectively analyzed the clinical data of 297 elderly patients who underwent FURL for unilateral upper urinary tract calculi at Beijing Hospital from January 2019 to September 2023.Patients were divided into elderly group(≥80 years)and low-middle aged group(≥60-<80 years).Propensity score matching(PSM)was used to match preoperative clinical data of patients.After PSM,the basic,perioperative and postoperative data of the two groups were compared.Results After PSM,116 patients were enrolled,including 58 patients in each group.The age[M(Q_(1),Q_(3))]of elderly group was 83.0(81.0,86.0)years,which included 29 males.The age of low-middle aged group was 69.5(64.8,74.0)years,which included 33 males.The duration of postoperative hospitalization[M(Q_(1),Q_(3))]in elderly group was longer than that in low-middle aged group[2(1,3)d vs 1(1,2)d,P=0.002].Serious postoperative complications occurred in 3 cases in the elderly group and 1 case in the low-middle aged group,respectively,without surgical intervention.There was no significant statistical difference in stone-free rate(SFR)[79.3%(46/58)vs 84.5%(49/58)],operation time[M(Q_(1),Q_(3)),70.0(48.3,100.0)vs 65.0(46.5,101.2)min]and postoperative complication rate[25.9%(15/58)vs 22.4%(13/58)]between two groups(all P>0.05).Conclusions In the treatment of upper urinary tract calculi in patients≥80 years,the SFR,operation time and postoperative complication rate of FURL are comparable to those in low-middle aged elderly patients.FURL has good safety and effectiveness in the treatment of upper urinary tract calculi in patients≥80 years.
作者
汤润华
王浩然
宋琉琪
刘建勇
逄城
王建龙
Tang Runhua;Wang Haoran;Song Liuqi;Liu Jianyong;Pang Cheng;Wang Jianlong(Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medicine Sciences,Beijing 100730,China;Graduate School of Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2024年第24期2229-2233,共5页
National Medical Journal of China
关键词
输尿管镜
老年
尿路结石
手术后并发症
回顾性队列研究
Ureteroscopes
Aged
Urinary calculi
Postoperative complications
Retrospective cohort studies
