神经源性膀胱患者输尿管镜碎石术后发病率及效果分析
作者：Matthew S. Christman, Angela Kalmus, Pasquale Casale 来源：Journal of Urology 日期：2013-03-12
导读
Morbidity and Efficacy of Ureteroscopic Stone Treatment in Patients with Neurogenic Bladder
Abstract
Purpose
There is a lack of information regarding the safety and efficacy of ureteroscopy (URS) in the neurogenic bladder (NGB) population. We hypothesized that URS in patients with NGB would be associated with increased risk of complications and lower stone clearance rates, when compared to those without neurologic impairment.
Materials and Methods
We reviewed a local registry of subjects with ICD-9 codes for urolithiasis between 2004 and 2012. The study cohort was assembled from all eligible NGB patients and a randomly selected control group that had undergone URS. Statistical analysis of demographic variables and surgical outcomes was performed. Complications were classified according to the Clavien system. Clearance was defined by CT, renal/bladder ultrasound, or direct ureterorenoscopy.
Results
URS was performed 173 times in 127 control subjects and 45 times in 20 subjects with NGB. There was no difference between the presenting episodes according to gender (p=1.0), race (p=0.654), or BMI (p=0.519). Bacteriuria was associated with the stone episode in 16.4% of control cases and in 67% of NGB cases (p<0.001). Median [IQR] operative times were significantly longer in those with NGB, 80.5 min [50-110.5] versus 52 min [33-78] (p=0.0003). The proportion of complications was significantly different (p=0.013). Stones cleared in 86.6% of control cases compared to 63% of NGB cases (p=0.004).
Conclusions
Patients with NGB have increased morbidity following URS for upper tract calculi compared to neurologically unaffected controls. Infection plays a role in this morbidity. Clearance rates are lower but stone burden is more significant in those with NGB.
http://www.jurology.com/article/S0022-5347(13)00377-7/abstract
分享：
相关文章
评论
我要跟帖发表
回复 小鸭梨：
发表
