Analysis Of Factors Influencing Residual Stones After Percutaneous Nephrolithotomy In Children

Objective:This study reviewed the clinical data(163 cases)of patients undergoing percutaneous nephrolithotomy(PCNL)in children under 14 years of age in the Department of Urology,Second Affiliated Hospital of Kunming Medical University,in order to understand the operation of this part of patients.Influencing factors of post-calculus residual,I hope to provide theoretical guidance for improving the net stone rate of PCNL after pediatric surgery,and provide theoretical reference for future clinical application of PCNL.Methods:Retrospective collection of clinical data from unilateral stage I PCNL in patients under 14 years of age in the Department of Urology,Second Affiliated Hospital of Kunming Medical University from June 2013 to January 1919.Including gender,age,affected side of the stone,preoperative renal function,preoperative urinary tract infection,preoperative hydronephrpsis,preoperative or non stone treatment history,stone size,stone type,stone position,intraoperative bleeding Situation,operation time,surgical puncture channel approach,number of surgical puncture channels,gravel method.The efficacy of stage I stone removal in children with PCNL was divided into residual stone group and Jingshi group(postoperative stone residue<4mm for the net stone group,?4mm for the residual stone group),the above factors that may affect the efficacy were measured by SPSS 19.0 The software was processed and analyzed,and the correlated single factor was analyzed by multivariate logistic binary regression analysis.P<0.05 was considered as statistically significant.Results:In this study,the residual stone rate of PCNL was 17.39%(28/161)and the net stone rate was 82.61%(133/161).Univariate analysis showed:gender,age,age grouping,calculus of the affected side,stone location,preoperative hydronephrosis,preoperative urinary tract infection,preoperative or non-calculus treatment history,surgical puncture channel approach,There was no significant correlation between the number of surgical puncture channels,the method of lithotripsy and the efficacy of PCNL after pediatric(P>0.05),stone size,stone type,stone size grouping,operation time,intraoperative bleeding,preoperative renal function and pediatric PCNL There was a significant correlation between postoperative outcomes(P<0.05).Multivariate logistic binary regression analysis showed that the influencing factors of correlation were analyzed by single factor analysis.The results showed that there was no significant correlation between the size of the stones,the intraoperative blood loss,the preoperative renal function and the postoperative outcome of PCNL.P>0.05),and stone size(P=0.046,,OR=0.811,95%C.L of OR:0.661-0.996),stone type(P=0.003,OR=4.634,95%C.L of OR:1.692-12.689),The operation time(P=0.003,OR=0.944,OR 95%C.L:0.909-0.980)was the main influencing factor for the residual stones after PCNL in children.Conclusion(s):1.Gender,age,age grouping,calculus of the affected side,stone location,preoperative hydronephrosis,preoperative urinary tract infection,preoperative or calculus treatment history,surgical puncture channel approach,surgery The number of puncture channels,lithotripsy,stone size grouping,intraoperative bleeding,and preoperative renal function were not the influencing factors of calculus residual after PCNL in children.2.Stone size,stone type and operation time are the main influencing factors of calculus residual after PCNL in children3.Preoperative planning and accurate intraoperative operation according to the condition before surgery is the key to reducing postoperative residual stones.