摘要
目的探讨单期体外冲击波碎石(ESWL)治疗输尿管结石成功率预测模型的建立以及检验其应用效果。方法回顾性分析2014年1月～2016年12月在我院行单期ESWL治疗的输尿管结石患者795例的临床资料,ESWL后随访3个月进行效果评估,分为成功组和失败组,前者指结石完全排出,而出现结石未排出、残余结石、多次ESWL、改为其他方式治疗等则归为失败组。用SPSS13.0统计软件建立数据库,比较性别、年龄、体重指数、结石部位、结石侧别、结石数目、结石CT值、结石表面积、肾盂分离情况、有无留置D-J管、结石是否活动等因素与单次ESWL成功率的关系,采用χ~2检验或者t检验对其进行单因素分析,找出与治疗成功率有关的因素;采用Logistic逐步回归分析的进行多因素分析,建立数学预测模型预测输尿管结石单次ESWL的成功率。结果本次研究795例患者,685例治疗成功,110例失败,治疗成功率为86.16%。单因素分析显示ESWL治疗成功率与患者年龄、体重指数、结石部位、结石数目、结石CT值、结石CR值、结石表面积、肾盂分离情况、有无留置D-J管、结石是否活动有关。Logistic多因素回归分析显示结石部位、结石数目、结石CT值、结石CR值、结石表面积、肾盂分离情况、有无留置D-J管、结石是否活动等构成单期ESWL成功率的独立相关因素,建立数学模型Logit P=6.957-2.006×结石数目-0.007×结石面积-0.423×结石部位-0.032×肾盂分离+2.637×结石活动-0.991×留D-J管-0.001×结石CR值-0.001×结石CT值。结论成功建立预测输尿管结石单期ESWL成功率的预测数学模型。
Objective To explore establishment and applicaton effect of single center ureteral calculi single stage ESWL treatment success rate prediction model. Methods 795 patients with ureteral calculi treated by single phase ESWL from January 2014 to December 2016 were retrospectively analyzed and were divided into the successful group and the failed group followed up for 3 months. Complete elimination of stones was classified as successful group, while failure group included failure of stones, residual stones, repeated ESWL, and change to other treatment methods. SPSS13.0 statistical software was used to establish the database. Gender, age, body mass index, stone location, stone side, number of stones, CT value of stones, stone surface area, pelvis separation, presence or absence of indwelling D-J tube, stone activity and other factors were compared with the success rate of single ESWL. X2 test or t test was used for univariate analysis to find out the factors related to the success rate of treatment. Logistic stepwise regression was used for multivariate analysis, and a mathematical prediction model was established to predict the success rate of single ESWL for ureteral calculi. Results Among the 795 patients of the study, 685 cases were successfully treated and 110 cases failed, with a treatment success rate of 86.16%. Single factor analysis showed that the success rate of ESWL treatment was related to the patient's age, body mass index, stone location, number of stones, CT value of stones, CR value of stones, stone surface area, renal pelvis separation, presence or absence of indwelling D-J tube, and stone activity. Logistic multivariate regression analysis showed that the site, number of stones, CT value of stones, CR value of stones, surface area of stones, separation of renal pelvis, presence or absence of indwelling D-J tube, and activity of stones were independent factors of success rate of single-stage ESWL. The mathematics model was established(Logit P= 6.957-2.006×number of stones-0.007×stone area-0.423×st
作者
薛清平
陈惠洪
张家彬
刘昌明
黄友锋
XUE Qingping;CHEN Huihong;ZHANG Jiabin;LIU Changming;HUANG Youfeng(Department of Urology,Mindong Hospital Affiliated to Fujian Medical University,Fuan 355000,China)
出处
《中国医药科学》
2019年第5期136-141,共6页
China Medicine And Pharmacy
基金
福建省宁德市指导性科技计划项目(20140027)
关键词
体外冲击波碎石
ESWL
输尿管结石
预测模型
建立
应用
Extracorporeal shock wave lithotripsy
ESWL
Ureteral calculi
Prediction model
Establishment
Application
