在患有结石的CKD患者中,尿路透镜和皮肤穿透性利切除术的比较结果:一种倾向匹配的队列研究
Jiun-Kai Chiou1, Jheng-Yan Wu2,3, Yu-Min Lin4
1Department of Urology, Taichung Veterans General Hospital, Taichung, Taiwan.
Frontiers in medicine
|October 20, 2025
概括
尿路透镜术 (URS) 与皮肤透神经切除术 (PCNL) 一样安全有效,用于治疗慢性病 (CKD) 患者的结石. 两种手术都显示了相似的5年重大脏不良事件,死亡率和透析依赖率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医学数据库 医学数据库
背景情况:
- 结石和慢性病 (CKD) 经常共存,共享风险因素,导致不良结果.
- 在CKD患者中,皮肤透神经切除术 (PCNL) 的安全性已经确立,但尿路透镜 (URS) 的安全性不太清楚.
研究的目的:
- 在患有CKD和结石的患者中,比较URS与PCNL的5年安全性和有效性.
- 为了评估主要的脏不良事件 (MAKE),所有原因的死亡率和URS和PCNL后透析依赖.
主要方法:
- 使用TrinetX数据库进行回顾性队列研究.
- 包括18岁以上的患有结石和慢性病的患者,不包括透析患者.
- 倾向分数匹配 (PSM) 用于平衡基线特征,比较每个组的723名患者 (URS与PCNL).
主要成果:
- 在URS和PCNL之间的5年重大脏不良事件 (MAKE) 率没有显著差异 (HR 0.93;95%CI 0.68-1.28).
- 所有原因的死亡率 (HR 0.98;95% CI 0.70-1.36) 和透析依赖 (HR 0.57;95% CI 0.23-1.38) 在两组之间也相似.
- 研究的局限性包括缺乏关于石块大小,位置和程序特定细节的数据.
结论:
- 尿路透镜术 (URS) 的安全性和疗效与皮肤透过性腎石切除术 (PCNL) 在慢性病 (CKD) 患者的结石治疗中相似.
- 在5年的时间里,在主要的脏不良事件,死亡率或透析依赖性方面没有发现显著差异.
- 需要进一步的研究来解决关于石材特性和程序细节的局限性.
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