Analysis Of Factor Affecting The Therapeutic Effect Of Extracorporeal Shock Wave Lithotripsy For Upper Urinary Calculi

ObjectiveTo investigate the factor influencing the therapeutic effect of ESWL on upper urinary calculi,and to provide scientific basis for the treatment of patients with upper urinary calculi.Methods130 patients with upper urinary tract stones in the urology department of the hospital on January 1,2017 and December 31,2018 were selected as objects.The patients were divided into groups less than 1000Hu,and≥1000Hu according to the CT value.According to the longest diameter of stone,they were divided into<10mm and 10-20mmu.According to body mass,patients were divided into BMI<25(kg/m~2)group and BMI≥25(kg/m~2)group.According to the distance between different skin and stones,the patients were divided into<100mm group and≥100mm group.All the patients were scheduled to receive ESWL treatment,and the patients were followed up for 3 weeks after surgery.Complete expulsion of stones was deemed a successful treatment,while failure of treatment was deemed a failure if stones were not discharged or there were residual stones.Patients’case data were checked,and gender,age,height,weight,course of disease,pain,hematuria,stone location,stone profile,longest diameter of stone,CT value,skin-to-stone distance,etc.of the patients were counted.Univariate and multivariate Logistic analysis was performed for stone types(urinary,renal and ureteral stones).All data in this study were processed by SPSS22.0software.Results1.All the 130 patients with upper urinary tract stones were treated wi th ESWL,54 patients were not treated with residual debris/lithotripsy,and76 patients were treated successfully,with a success rate of 58.46%.All t he patients completed CT examination,including 54 cases in the group le ss than 1000Hu,and 76 cases in the group≥1000Hu.The effective rate of gravel in the group<1000Hu was higher than that in the group≥1000Hu(P<0.05).2.The effective rate of macadam in the longest diameter of stone<10mm group was higher than that in the 10-20mm group(P<0.05).Debris residue and gravel inefficiencies in the<10mm group were lower than tho se in the 10-20mm group(P<0.05).3.There was no significant difference in the lithotripsy success rate b etween the BMI<25(kg/m2)group and the BMI≥25(kg/m2)group(P<0.05).4.There was no significant difference in the success rate of lithotrips y between<100mm group and≥100mm group(P<0.05).5.Single factor results showed that the ESWL treatment effect of pati ents with upper urinary tract stones was not statistically significant with ge nder,height,age,lateral calculus,BMI,SSD(P>0.05).It was significantly related to course of disease,pain,hematuria,stone location,maximum dia meter of stone,CT value(P<0.05).6.Logistic regression analysis results showed that the ESWL treatme nt effect of patients with upper urinary tract stones had statistical significa nce with course of disease,stone size and CT value(P<0.05).Conclusions1.ESWL can achieve good effect in patients with upper urinary tract stones,and its effect is related to the course of disease,stone size and CT value.2.The effect of ESWL treatment in patients with upper urinary tract c alculi influence factors is more,the urinary crystals in patients with the in the course of disease≥3 months,the maximum diameter of stone of 10-20 mm and CT value of≥1000Hu for risk factors.Therefore,effective mea sures should be developed for clinical intervention according to the above risk factors to improve the success rate of ESWL.