体重指数与肾结石ESWL治疗后常见并发症的关系

目的 探讨体重指数（BMI）与体外冲击波碎石术（ESWL）术后常见并发症的关系。方法 选取2020年1月至2020年12本院收治的213例因肾结石需行ESWL治疗的患者，按《中国成人超重和肥胖症预防控制指南》分为A组（58例，BMI<18.5 kg/m²）、B组（120例，18.5 kg/m²≤BMI<24 kg/m²）、C组（35例，BMI≥24 kg/m²）。比较三组患者术前1 d和术后第1天的血肌酐和血中性粒细胞明胶酶相关脂质运载蛋白(NGAL)，术后第1天复查泌尿系B超，按Clavien-Dindo分级对各组术后并发症进行评分并进行比较。结果 213例患者的碎石能量为（95.4±15.1）J,冲击次数为（1 230±310）次，碎石时间（21.6±10.2）min。与术前1 d相比，三组术后1 d的NGAL升高，差异有统计学意义（P<0.05）。 与C 组相比，A、B组术后1 d的血肌酐、NGAL升高，差异均有统计学意义（均P<0.05）；与B组相比，A组术后1 d的血肌酐、NGAL升高，差异均有统计学意义（均P<0.05）。A组出现Clavien Ⅰ级并发症者8例、Clavien Ⅱ级并发症者4例，Clavien Ⅲ级并发症者1例；B组出现Clavien Ⅰ级并发症者6例、Clavien Ⅱ级并发症者2例，C组出现Clavien Ⅰ级并发症者2例，三组并发症比较，差异有统计学意义（P<0.05）。结论 BMI对于肾结石ESWL术后出现并发症有一定影响，BMI越低出现术后常见并发症概率越大。

A study on the relationship between body mass index and common complications after extracorporeal shock wave lithotripsy treatment for kidney stones

Objective  To investigate the relationship between body mass index (BMI) and common complications after extracorporeal shock wave lithotripsy (ESWL).Methods  A total of 213 patients who needed ESWL due to kidney stones in our hospital from January 2020 to November 2020 were enrolled. According to the guidelines for prevention and control of overweight and obesity among Chinese adults, the patients were divided into three group. Group A (58 cases, BMI<18.5  kg/m²), group B (120 cases, 18.5 kg/m²≤BMI<24 kg/m²) and group C (35 cases, BMI≥24 kg/m²). The serum creatinine and serum neutrophil gelatinase-associated lipocalin (NGAL) levels were compared between preoperative and postoperative day 1. The urinary system B-ltrasound was reexamined on postoperative day 1. The postoperative complications of ESWL in each group were scored and compared according to Clavien-Dindo classification.Results  The average lithotriptic energy of the 213 patients was (95.4±15.1) J, the average number of shocks was (1 230±310), and the average lithotriptic time was (21.6±10.2) min.Compared with 1 day before operation, there was significant difference in NGAL of the three groups 1 day after operation (P<0.05). Compared with group C, creatinine and NGAL in group A and B were significantly increased 1 day after ESWL operation, and the differences were statistically significant（all P<0.05）. Compared with group B, creatinine and NGAL in group A were significantly increased 1 day after ESWL operation, and the differences were statistically significant（all P<0.05）. In group A, 8 cases had Clavien Ⅰ complications, 4 cases had Clavien Ⅱ complications, and 1 case had Clavien Ⅲ complications. In group B,  6 cases had Clavien Ⅰcomplications, 2 cases had Clavien Ⅱ complications. In group C, 2 cases had ClavienⅠcomplications, there were significant differences in complications among the three groups (P<0.05).Conclusions  BMI has a certain influence on postoperative complications of kidney stones after ESWL.The lower the BMI, the higher the risk of common postoperative complications.