经皮肾镜碎石术后双J管相关严重并发症危险因素的Logistics回归分析

目的：探讨经皮肾镜碎石术（percutaneous nephrolithotomy, PCNL）后双J管留置相关严重并发症的危险因素。方法依标准筛选2014年1月~2016年4月泌尿外科PCNL术治疗上尿路结石并留置双J管病例272例，运用SPSS统计软件对可疑危险因素行二分类单变量Logistics回归筛选，有统计学意义之因素再行多变量Logistics回归逐步分析。结果共63例患者发生较严重的双J管相关并发症（发生率23.1%），筛选后具有统计学意义的危险因素包括：输尿管异常（β=1.735，P=0.000，OR=5.670）、留置时间（β=1.206，P=0.028，OR=3.340）、性别（β=0.895，P=0.016，OR=2.446）、术前控制欠佳的尿路感染（β=0.849，P=0.020，OR=2.338）和粗细型号（β=0.847，P=0.011，OR=2.333）。结论男性是PCNL术后双J管严重并发症的危险人群，为减少其发病率，须积极控制尿路感染，术前术中发现输尿管异常时，谨慎选择双J管粗细型号，术后恢复良好的情况下应尽早拔管，减少留置时间。

Logistic regression analysis of risk factors of serious complications related with double-J ure-teral stenting following percutaneous nephrolithotomy

Objective To investigate the risk factors of the serious complications related with double-J ureteral stent placement following percutaneous nephrolithotomy (PCNL). Methods Clinical data were reviewed for 272 patients treated with PCNL and indwelling double-J stents between January, 2014 and April, 2016. The risk factors of serious complications were identified using univariate and multivariate logistic regression analysis. Results Serious complications of double-J ureteral stenting occurred in 63 patients (23.1%). Univariate and multivariate logistic regression analysis indicated that the ureter abnormalities (β=1.735, P=0.000, OR=5.670), stent indwelling duration (β=1.206, P=0.028, OR=3.340), gender (β=0.895, P=0.016, OR=2.446), preoperative urinary tract infection (β=0.849, P=0.020 , OR=2.338) and stent size (β=0.847, P=0.011, OR=2.333) were all risk factors of serious complications related with the procedure. Conclusion Male patients are exposed to a higher risk of serious complications following PCNL. Effective management of urinary tract infection and choice of appropriate stent size in cases of ureteral abnormalities help to reduce these complications. The double-J stent should be withdrawn as soon as possible in patients with good postoperative recovery.