目的：探讨结石CT值对输尿管软镜钬激光清除单发肾结石效果的预测作用。方法:回顾性分析我院行输尿管软镜钬激光碎石治疗的133例单发肾结石患者的临床资料, 根据测量的平均结石CT值分为低值组(CT值＜800 HU, n＝70)和高值组(CT≥800 HU, n＝63)。比较两组结石清除率、手术时间及手术并发症。采用Logistic 多因素回归分析探讨输尿管软镜钬激光清除单发肾结石效果的影响因素。结果：低值组与高值组在性别、年龄、结石直径、结石部位、合并疾病等一般资料方面比较, 无统计学差异(P＞0.05)。低值组和高值组结石清除率分别为92.86%、76.19%, 两组差异比较有统计学意义(P＜0.05); 手术时间分别为(83.23±12.71) min、(119.40±16.35) min, 两组差异比较有统计学意义(P＜0.05); 手术并发症发生率分别为4.29%、17.46%, 两组差异比较有统计学意义(P＜0.05)。Logistic多因素回归分析显示, 结石CT值、手术时间是影响结石清除率的独立风险因素。结论:结石 CT 值对输尿管软镜钬激光碎石时间、结石清除率有一定预测价值。

Objective: To discuss the predictive effect of CT value of renal calculi on exible ureteroscopy with holmium laser lithotripsy. Methods: 133 cases of patients with single renal calculi performed by flexible ureteroscopy with holmium laser lithotripsy in our hospital were analyzed retrospectively, according to the measured mean CT value of calculus, the patients were divided into low-value group (CT value<800 HU, n=70) and the high-value group (CT value≥800 HU, n=63). The renal calculi removal rate, operation time and complications were compared between the two groups.Logistic multivariate regression analysis was used to investigate the influencing factors of flexible ureteroscopy with holmium laser lithotripsy removing single renal calculi. Results: There was no statistically significant difference between low-value group and high-value group in general data such as gender, age, calculi diameter, calculi site, and disease association (P>0.05). The calculi clearance rates of low-value group and high-value group were 92.86% and 76.19%, respectively. The difference between the two groups was statistically significant (P<0.05).The operative time was (83.23±12.71) min and (119.40±16.35) min, respectively. The difference between the two groups was statistically significant (P<0.05).The incidence of surgical complications was 4.29% and 17.46%, respectively, with statistically significant differences between the two groups (P<0.05).Logistic multivariate regression analysis showed that CT value and operation time of calculus were independent risk factors affecting calculi clearance rate. Conclusion: CT value of calculi has certain predictive value for lithotripsy time, calculi clearance rate of flexible ureteroscopy with holmium laser lithotripsy.