摘要
Abstract
Objective Toanalyzethehighriskclinicalandimagingcharacteristicsofpatientswiththeplacement difficultyofureteralaccesssheath(UAS)inthefirstretrogradeintrarenalsurgery(RIRS).Methods Atotalof142patients with calculus of upper urinary tract(119 with unilateral ureteral obstruction,23 with bilateral ureteral obstruction,165 sides), who underwent RIRS in the Second Affiliated Hospital of Zhengzhou University from September 2014 to May 2016,were selected. According to whether success placing UAS or not during treatment, patients were divided into success placement group and difficulty placement group. The clinical characteristics and imaging characteristics of patients were collected. Multivariate LogisticregressionwasusedtoanalyzetheinfluencingfactorsofthedifficultyinplacingUAS.Results Thesuccessplacement group had 118 patients,and 141 sides totally. While the difficulty placement group had 24 patients and 24 sides. There was significant difference in indwelling history of D-J tube,ureteroscopic surgery history,incidence of ureteral dilation,nephrarctia, and ureteral development degree of intravenous pyelogram( IVP)for 30 minutes in the affected side between two groups( P<0. 05). Multivariate Logistic regression analysis showed that indwelling history of D-J tube in the affected side〔OR =0. 111, 95%CI(0. 013,0. 928)〕,the history of ureteroscopic surgery in the affected side〔OR=0. 102,95%CI(0. 012,0. 867)〕were the predictive factors of the placement success of UAS ( P <0. 05 ), no ureteral image in the 30 -minute IVP〔OR =4. 562,95%CI(1. 388,14. 992)〕was the predictive factor of the placement difficulty in UAS(P<0. 05). Conclusion TheindwellingD-JtubeandhistoryofureteroscopicsurgerycanreducetheriskoftheplacementdifficultyinUAS,andno ureteral iamge in the 30 -minute IVP increases the risk of the placement difficulty in UAS. Therefore,pay attention to the clinical and imaging data of patients before RIRS can effectively assess the occurrence risk of the placement difficulty in UAS.关键词
输尿管结石/输尿管镜检查/输尿管导入鞘Key words
Ureteral calculi/Ureteroscopy/Ureteral access sheath分类
医药卫生
