【摘要】 目的 探讨输尿管软镜碎石术后患者发生肾包膜下出血的危险因素。方法 收集2023年01月-2024年12月在本院接受输尿管软镜碎石手术的313例患者的临床资料，将手术后发生肾包膜下出血的患者纳入术后出血组，其余患者纳入术后未出血组。统计两组患者的临床资料，对影响输尿管软镜碎石术后患者发生肾包膜下出血的因素进行分析。结果 在313例患者中，9例术后发生肾包膜下出血，304例术后未发生肾包膜下出血。卡方检验分析表明，年龄≥60岁、合并糖尿病、高血压、中/重度肾积水、尿路感染、肾功能不全是影响输尿管软镜碎石术后患者发生肾包膜下出血的因素(P<0.05);Logistic回归分析表明，年龄≥60岁、糖尿病、高血压、中/重度肾积水、尿路感染、肾功能不全是输尿管软镜碎石术后患者发生肾包膜下出血的独立危险因素(P<0.05)。结论 输尿管软镜碎石术后患者发生肾包膜下出血的危险因素包括年龄≥60岁、糖尿病、高血压、中/重度肾积水、尿路感染及肾功能不全，术前存在上述因素时，需积极采取应对措施。更多还原

【Abstract】 Objective To investigate the risk factors of renal subcapsular hemorrhage after flexible ureteroscopic lithotripsy. Methods Clinical data were retrospectively collected from 313 patients who underwent flexible ureteroscopic lithotripsy at our hospital between January 2023 and December 2024. Patients diagnosed with postoperative renal subcapsular hemorrhage were assigned to the bleeding group, while those without such complications were classified into the non-bleeding group. Comparative statistical analysis was performed on the clinical characteristics of both groups to identify potential risk factors associated with renal subcapsular hemorrhage following flexible ureteroscopic lithotripsy. Results Among the 313 patients, 9 were diagnosed with postoperative renal subcapsular hemorrhage, while 304 did not exhibit this complication. Chi-square test analysis revealed that age ≥60 years, diabetes mellitus, hypertension, moderate to severe hydronephrosis, urinary tract infection, and renal insufficiency were significantly associated with the occurrence of renal subcapsular hemorrhage following flexible ureteroscopic lithotripsy(P<0.05). Multivariate logistic regression analysis further identified these factors—age ≥60 years, diabetes mellitus, hypertension, moderate to severe hydronephrosis, urinary tract infection, and renal insufficiency—as independent risk factors for postoperative renal subcapsular hemorrhage(P<0.05). Conclusions The risk factors for renal subcapsular hemorrhage following flexible ureteroscopic lithotripsy include age ≥60 years, diabetes mellitus, hypertension, moderate to severe hydronephrosis, urinary tract infection, and renal insufficiency. The presence of these preoperative risk factors warrants proactive clinical management to mitigate potential complications.更多还原