尿路镜术后的尿路,IV型结石的手术内识别可能会改变临床实践
Maxime Pattou1, Laurent Yonneau2, Amaury de Gouvello3
1Louis University Hospital, Paris, France. maxime.pattou@gmail.com.
World journal of urology
|September 21, 2024
概括
柔性尿路透镜术 (F-URS) 后的尿路透症是一种显著的并发症. 第四种类型的石头 (carbapatite或 struvite) 与风险增加密切相关,需要谨慎管理.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
背景情况:
- 尿道是灵活尿道镜术 (F-URS) 后的一个主要并发症,占4.3%的病例.
- 它对医疗保健资源构成重大负担,导致成人败血症发作和医院支出.
研究的目的:
- 为了确定预测F-URS后尿道炎风险的临床参数.
- 分析与术后泌尿失调相关的风险因素.
主要方法:
- 一项前性多中心研究,涉及432名患者,他们在2016年6月至2018年6月期间接受了F-URS用于微积分的患者.
- 收集的数据包括临床,细菌学,石材特征和手术内细节.
- 进行了统计分析,以确定术后泌尿失调的危险因素.
主要成果:
- 在486次F-URS手术中,18名患者 (4%) 患有术后泌尿失调症.
- 显著的危险因素包括冠状动脉衰竭,更大的石径,阳性手术前尿液培养和IV型结石组成 (碳酸盐或石灰石).
- 多变量分析确定IV型石头是唯一显著的预测因子 (OR=14.0,p=0.025).
结论:
- 通过尿路透镜治疗IV型结石 (碳酸或斯特鲁维特) 会增加手术后尿路的风险.
- 在手术期间识别IV型结石应该促使皮质尿样和扩展的临床监测.
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