结石密度变异系数对泌尿系结石冲击波碎石术成功率的影响
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崔凯，孙婷，张学颖
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1. 武警山东总队医院泌尿外科，山东济南，250014；2. 山东省公共卫生临床中心创伤与关节外科，山东济南，250000
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摘要：目的 探讨结石密度变异系数（VCSD）对泌尿系结石冲击波碎石术（SWL）成功率的影响。方法 选择2024 年1 月至2025 年3 月在我院接受ESWL 治疗的泌尿系结石患者143 例作为研究对象，根据碎石效果将患者分为非残石组101 例和残石组42 例。观察2 组患者VCSD 差异，比较平均结石密度（MSD）、皮石距离（SSD）、结石体积、结石位置及年龄、性别、病程、糖尿病、结石侧、体质量指数（BMI）等，采用多因素Logistic回归分析VCSD对碎石效果的影响。结果 残石和非残石患者VCSD、MSD、SSD、结石体积、结石位置等均存在统计学意义（P ＜ 0.05）。残石和非残石患者年龄、性别、结石侧相比较差异均无统计学意义（P ＞ 0.05），残石和非残石患者病程、糖尿病、BMI 相比较差异存在统计学意义（P ＜ 0.05）。多因素Logistic 回归分析结果显示，VCSD 是影响碎石效果的保护性因素（P＜0.05），风险因素包括MSD、结石体积、病程（P＜0.05）。结论 VCSD是ESWL疗效的独立预测因素，为临床评估结石易碎性提供了新的量化工具。
关健词：泌尿系结石；体外冲击波碎石；结石密度变异性；影响因素
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Effect of the coefficient of variation of stone density on the success rate of shock wave lithotripsy for urinary tract stones
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Kai Cui, Ting Sun, Xueying Zhang
1. Department of Urology, Shandong Armed Police Corps Hospital, Jinan, Shandong 250014, China; 2. Trauma and Joint Surgery Department of Shandong Provincial Public Health Clinical Center, Jinan, Shandong 250000, China
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Abstract：Objective To study the effect of variation coefficient of stone density (VCSD) on the success rate of shock wave lithotripsy (SWL) for urinary tract stones. Methods 143 patients with urinary tract stones who received ESWL treatment in our hospital from January 2024 to March 2025 were selected as the research subjects. According to the stone fragmentation effect, the patients were divided into a non residual stone group with 101 patients and a residual stone group with 42 patients. The difference in VCSD between two groups of patients was observed. The mean stone density (MSD), skin stone distance (SSD), stone Volume, stone location, age, sex, course of disease, diabetes, stone side, body mass index (BMI), etc. were compared, and the multifactor logistic regression was used to analyze the impact of VCSD on the lithotripsy effect.Results There were statistically significant differences in VCSD, MSD, SSD, stone volume, and stone location between residual and non residual stone patients (P<0.05). There was no significant difference in age, sex and stone side between residual stone patients and non residual stone patients (P>0.05), but there was significant difference in disease course, diabetes and BMI between residual stone patients and non residual stone patients (P<0.05). The results of multiple logistic regression analysis showed that VCSD was a protective factor affecting the stone fragmentation effect (P<0.05), and risk factors included MSD, stone volume, and disease duration (P<0.05). Conclusion VCSD is an independent predictor of ESWL efficacy, providing a new quantitative tool for clinical assessment of stone fragility.
Keywords : Urinary tract stones; Extracorporeal shock wave lithotripsy; Variability of stone density; influencing factors
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