经皮肾镜取石术后胸膜损伤的发生情况及相关因素分析OA

Objective To analyze the incidence and related factors of pleural injuries after percutaneous nephrolithotomy(PC-NL).Methods A retrospective analysis was conducted on clinical data of 78 patients who underwent PCNL via the 12th rib superior approach in the Department of Urology of Anhui Provincial Corps Hospital of Chinese People's Armed Police Force from February 2023 to May 2025.The basic information(gender,age,BMI,stone size,disease duration,and complications),surgical conditions(side of surgery,stone location,puncture calyx,puncture approach),and the relationship between the costoclavicular angle(VA)and pleural injury were evaluated.Results A total of 78 patients underwent PCNL via the 12th rib superior approach.There was no rela-tionship between the gender,age,BMI,stone size,duration of illness,complications,side of surgery,stone location,and chest inju-ries among the patients.14 patients developed pleural injuries,which were divided into a pleural injury group,including 8 cases of pneumothorax,5 cases of pleural effusion,and 1 case of hemothorax,and 64 patients did not have pleural injuries,which were divided into a control group.The constituent ratio of pleural injuries was significantly higher when the puncture site was in the superior calyx than when it was in the middle and lower calyces;the constituent ratio of pleural injuries was higher in the 10th intercostal space than in the 11th intercostal space(5/9 vs.4/60),and the differences were statistically significant(P<0.05);the number of cases with RVA 40°-45° in the pleural injury group was significantly higher than that with RVA46°-50° and RVA>50°,and the number cases with RVA 40°-45° in the control group was significantly lower than that with RVA46°-50° and RVA>50;when compared between groups,the percentage of cases with RVA40°-45° and RVA>50° was significantly different;the mean RVA in pleural injury group was significantly lower than that in the control group[(44.32°±3.46°)vs.(52.17°±4.32°)],and the differences were statistically significant.Conclusions The higher the puncture site in the superior calyx of the kidney and the smaller the RVA,the greater the chance of pleural injury;RVA is closely related to pleural injuries and can be used as an important predictive factor for the occurrence of pleural injuries after PCNL.