摘要
Abstract
Objective To investigate the associated factors of systemic inflammatory response syndrome(SIRS) and residual stones after flexible ureteroscopic holmium laser lithotripsy for calyceal diverticular stones.Methods The 30 participants enrolled in this study were from the Second Affiliated Hospital of Zhengzhou University,they were diagnosed with calyceal diverticular stones between September 2012 and July 2015 by kidney-ureter-bladder(KUB) abdominal radiography combined with intravenous pyelography(IVP) or CT urography(CTU) and treated by flexible ureteroscopic holmium laser lithotripsy.Postoperative SIRS occurred in the participants were observed and recorded.CT plain scanning was performed in all of them at the time of 1,3 months after the surgery for detecting the residual stones in bilateral kidneys.Results The average intraoperative duration,intraoperative blood loss and postoperative hospital stay was(67.3±21.2)min,(7.0±4.1) ml,(4.1±2.7) days,respectively.Twenty percent of them(6/30) had postoperative SIRS,but no urosepsis and septic shock after receiving the treatment against infection,fluid infusion and other symptomatic treatment.The residual stone rate detected by the CT scanning performed at the time of 1,3 months after the surgery was 20.0%(6/30),and 16.7%(5/30),respectively.Among the participants,the incidence of SIRS was significantly associated with diabetes,intraoperative infection,and infection-related stone fragments(P<0.05),while it was not associated with gender,age,kidney stone size,location and amount,angle between the renal pelvis and calyce(P>0.05);the incidence of postoperative residual stones was substantially associated with kidney stone location and angle between the renal pelvis and calyce(P<0.05),but not with gender,age,kidney stone size and amount,diabetes,intraoperative infection,and infection-related stone fragments(P>0.05).Conclusion Ureteroscopic holmium laser lithotripsy is one of the safe and effective ways for the treatment of calyceal diverticular stones.For patients with the risk factors for SIRS,attention should be paid to the prevention and treatment of postoperative infection;for those with the risk factors for residual stones,surgical method and management option for residual stones should be selected carefully.关键词
肾结石/输尿管镜检查/全身炎症反应综合征/影响因素分析Key words
Kidney calculi/Ureteroscopy/Systemic inflammatory response syndrome/Root cause analysis分类
医药卫生
