| Objective: To discuss the related factors of interventional embolization for bleeding after percutaneous nephrolithotomy.Method:A retrospective analysis of the clinical data of 96 patients who underwent percutaneous nephrolithotomy in the Department of Urology,the First Affiliated Hospital of Fujian Medical University from May 2015 to December 2020.Patients were divided into a case grouprol group according to whether there was postoperative bleeding or not.There were 32 cases in the case group and 64 cases in the control group,a total of 96 cases.Collect perioperative related indicators,comparing the demographic characteristics and calculi characteristics of the two groups before surgery,and analyze the operation time,puncture site,number of channels,percentage of hemoglobin reduction,surgical staging,etc.in the 2 groups.Result: A total of 96 subjects were included in this study,including 64 controls and 32 cases;the average age was 53.26±13.58 years;75 males and 21 females.There were 50 males and 14 females in the control group,and 25 males and 7 females in the case group.The average operation time of all patients was 68.0±46.4 minutes,and the median operation time of the control group was 56.5 minutes and 76.5 minutes,respectively.The gender,age,body mass index(BMI),history of diabetes,urinary tract infection,stone characteristics of the two groups were cast stones,side of the stones,number of calculus distribution,and the size of the surgical channel,puncture site,and stage of the two groups There was no statistically significant difference in the length of operation and operation(P>0.05);while there were statistically significant differences in the two groups of patients with renal insufficiency,history of kidney surgery,multiple stones,GSS score,and the percentage of early postoperative hemoglobin reduction.(P<0.05).Univariate analysis showed that renal insufficiency,history of kidney surgery,single/multiple stones,number of surgical channels,early postoperative hemoglobin reduction percentage,GSS score and minimally invasive percutaneous nephroscope bleeding after interventional embolization are related(P< 0.05),and the multivariate logistics regression analysis showed that the early postoperative hemoglobin reduction percentage,GSS grade three/four,and multi-channel surgery were independent influencing factors for minimally invasive percutaneous nephroscopy bleeding after interventional surgery(P<0.05).The ROC curve analysis was performed on the independent influencing factors of minimally invasive percutaneous nephroscopy hemorrhage and interventional embolization in the multivariate logistics regression analysis.It was found that the early postoperative hemoglobin reduction percentage diagnostic curve AUC was 0.720(95%CI: 0.602-0.838,P<0.001),with a cut-off value of 14.14%.Combine the three variables of early postoperative hemoglobin reduction percentage,GSS score,and number of surgical channels to perform ROC curve analysis,and perform joint diagnosis to predict the outcome.The results show that the full model(early postoperative hemoglobin percentage,GSS score,number of surgical channels)The AUC was 0.811,which was better than the single index of early postoperative hemoglobin reduction in predicting the outcome.Conclusion: The percentage of hemoglobin reduction,high level of GSS(GSS level 3 and level 4),and the establishment of multi-channel surgery are independent influencing factors for the occurrence of bleeding after percutaneous nephroscopy for interventional surgery.The three variables of hemoglobin reduction percentage,GSS score,and number of surgical channels were analyzed by ROC curve,and combined diagnosis was used to predict the outcome of interventional embolization surgery for bleeding after percutaneous nephroscopy,which was better than a single index of hemoglobin reduction in predicting this outcome. |
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