小儿微型 PCNL 后部分结石清除的决定因素

Javed Altaf Jat, Muhammad Murtaza Azad, Syed Daniyal Raza
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The risk estimation was analyzed with the help of the odds ratio test. Result: A total of 234 participants with mean age of 6.4 ± 4.8 years were enrolled. Stone clearance was reported 203 (86.7%) and 31 (13.2%) residual fragments. 09 (3.8%) out of the residual stone group needed intervention for complete clearance while the remaining were reported as stone free after 4 weeks with METs. The mean residual stone size was 0.7 ± 0.3, upon assessing the determinants maximum patients had Staghorn (> 4) cms stone size with 7 (2.9%) of patients out of 13 (5.5%). The odds of having partial clearance were reportedly positive with 2.34 in staghorn ≥ 4cms stone size and 1.62 in Grade IV Guy’s stone score. 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摘要

摘要: 背景:在巴基斯坦,儿科肾结石的发病率越来越高,为了尽量减少肾结石疾病的不良后果,必须进行准确的诊断和适当的治疗。研究目的本研究旨在评估巴基斯坦儿科人群在微型 PCNL 术后部分结石清除的风险因素。材料和方法:本研究是一项回顾性横断面研究,于 2021 年在卡拉奇戈德拉医院进行,研究对象为确诊为单发或多发肾结石、需要进行 PCNL 的患者,采用盖氏结石评分作为完全清除结石的预测方法。使用 SPSS 22 版分析数据,使用卡方检验评估数据的显著性,以 p 值≤0.05 为显著。风险估计借助几率比验进行分析。结果共有 234 名参与者参加了研究,平均年龄为 6.4 ± 4.8 岁。结石清除率为 203(86.7%),残余碎片为 31(13.2%)。残余结石组中有 09 人(3.8%)需要干预才能彻底清除结石,其余的人在使用 METs 4 周后均无结石。残余结石的平均大小为 0.7 ± 0.3,在评估决定因素时,13 例(5.5%)患者中有 7 例(2.9%)患者的结石大小为鹿角状(> 4 厘米)。据报道,结石大小≥4 厘米的患者部分清除的几率为 2.34,结石评分为 IV 级的患者部分清除的几率为 1.62。结论结石大小≥ 4.0 厘米和所有肾盏中均存在鹿角状结石是迷你 PCNL 术后结石部分清除的独立风险因素。
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Determinants of Partial Stone Clearance after Mini-PCNL in the Pediatric Population
Abstract: Background: The prevalence of renal stones in pediatric population is increasing in Pakistan, to minimize the adverse outcomes of renal stone disease accurate diagnosis and proper management is necessary. Objective: This study aim to evaluate the risk factors of partial stone clearance after mini-PCNL in the pediatric population of Pakistan. Materials and Methods: This is a retrospective, cross-sectional study conducted at Godhra Hospital, Karachi, during 2021, patients diagnosed with single or multiple renal stones requiring PCNL were enrolled in the study, Guy’s stone score was used as a prediction method for complete clearance. SPSS version 22 was used to analyze the data, chi-square test was used to assess the significance of the data keeping a p-value ≤0.05 as significant. The risk estimation was analyzed with the help of the odds ratio test. Result: A total of 234 participants with mean age of 6.4 ± 4.8 years were enrolled. Stone clearance was reported 203 (86.7%) and 31 (13.2%) residual fragments. 09 (3.8%) out of the residual stone group needed intervention for complete clearance while the remaining were reported as stone free after 4 weeks with METs. The mean residual stone size was 0.7 ± 0.3, upon assessing the determinants maximum patients had Staghorn (> 4) cms stone size with 7 (2.9%) of patients out of 13 (5.5%). The odds of having partial clearance were reportedly positive with 2.34 in staghorn ≥ 4cms stone size and 1.62 in Grade IV Guy’s stone score. Conclusion: Stone size ≥ 4.0 cm and staghorn calculi present in all calyces are independent risk factors for partial stone clearance after Mini-PCNL.
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