基于列线图模型的输尿管软镜碎石术后结石残余的风险评估OACSTPCD

Objective:To explore the risk factors of residual calculi after flexible ureteroscopic lithotripsy(FURL)in patients with renal calculi,and to develop a risk warning model of nomogram.Methods:A total of 120 patients with renal calculi who underwent FURL from Jan.2021 to Jan.2023 were selected and divided into residual group and clean group according to whether the patients had residual stones after operation.Logistic regression analysis was performed on the related factors,and a nomogram risk model was con-structed and verified.Results:The results of factor analysis showed that the location of stones,multiple stones,infundibulopelvic angle(IPA),the number of renal calices involved,the positive culture result of preoperative midstream urine,and the diameter of stones were the influencing factors of residual stones after FURL in patients with renal calculi.Among them,the large diameter of stones,the location of stones,multiple stones,IPA＜45° and the number of renal calices involved≥2 were independent risk factors(P＜0.05,OR＞1).The results of Hosmer-Lemeshow goodness-of-fit test showed that χ2=1.474,P=0.993,the area under the receiver operating characteristic curve was 0.947(P＜0.001,95%CI=0.900～0.993),the sensitivity was 81.80%,the specificity was 94.90%,and the maximum Youden index was 0.767.The overall trend of the calibration curve predicted by the model for residual stones after FURL in patients with renal calculi was basically consistent with the ideal curve.The model regression equation was Logit(P)=0.193×stone diameter+1.717×stone location+3.141×multiple stones+2.373×IPA+2.626×number of involved calyces-10.987.Conclusions:The residual cal-culi after FURL in patients with renal calculi are affected by a variety of factors.The risk early warning model developed according to its risk factors has good predictive efficacy.