同期输尿管软镜手术治疗双侧直径2～3cm输尿管上段结石的疗效观察

doi:10.3969/j.issn.1005-6483.2020.07.026

摘要/Abstract

摘要： 目的探讨同期输尿管软镜手术治疗双侧直径2～3cm输尿管上段结石的临床疗效。
方法 2016年1月～2018年12月84例本院接受治疗的双侧直径2～3cm输尿管上段结石病人84例，根据手术方法不同分为观察组和对照组。观察组40例，采用同期输尿管软镜手术，对照组44例，采用分期输尿管软镜手术。比较两组病人的手术指标、结石清除率、医疗费用、炎症因子水平、尿常规、血常规以及并发症情况。
结果观察组总手术时间、术中出血量、住院时间及医疗费用均少于对照组（P＜0.05）。观察组病人结石清除率为100.00%，对照组为93.18%，两组比较差异无统计学意义（P＞0.05）。两组病人术后3天的肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、超敏C-反应蛋白（hs-CRP）、血白细胞、尿白细胞水平高于术前，差异有统计学意义（P＜0.05），但两组间术后 TNF-α、IL-6、hs-CRP、血白细胞、尿白细胞水平比较差异无统计学意义（P＞0.05）。观察组术后总并发症率（7.50%）低于对照组（25.00%），差异有统计学意义（P＜0.05）。
结论同期输尿管软镜手术对双侧2～3cm输尿管上段结石具有显著疗效，无需二次手术，可减少术中出血量、麻醉次数，缩短手术时间、住院时间，降低并发症风险。

关键词: 输尿管上段结石, 输尿管软镜, 同期手术, 双侧

Abstract: Objective In order to investigate the clinical effect of simultaneous ureteral soft-scopy surgery on bilateral 2～3 cm upper ureteral stones，and to provide a reference for clinical treatment options，this study retrospectively analyzed 84 cases with bilateral 2-3 cm upper ureteral stones in our hospital from January 2016 to December 2018.The study subjects were divided into observation group（40 cases）and control group（44 cases）according to the surgical method.The observation group was treated with simultaneous ureteral soft endoscopic surgery，and the control group was treated with staged ureteral soft endoscopic surgery.The operation indexes，stone removal rate，medical expenses，level of inflammatory factors，urine routine，blood routine and complications of the two groups were compared.The total operation time，intraoperative hemorrhage，hospitalization time and medical expenses of the observation group were less than those of the control group（P<0.05）.The stone clearance rate of the observation group and the control group was 100.00% and 93.18%，respectively，with no significant difference（P>0.05）.The levels of TNF - α，IL-6，hs CRP，WBC and uroleukocyte in the two groups were significantly higher than those before operation（P<0.05），but there was no significant difference in the levels of TNF - α，IL-6，hs CRP，WBC and uroleukocyte between the two groups（P>0.05）.The total postoperative complication rate in the observation group（7.50%）was significantly lower than that in the control group（25.00%），and the difference was statistically significant（P<0.05）.
Conclusions indicate that simultaneous ureteral soft-scopy surgery has a significant effect on bilateral 2～3 cm upper ureteral stones.It can improve the clearance rate of primary stones and eliminate the need for secondary surgery.The length of hospital stay reduces the risk of complications.

Key words: upper ureteral stones; , soft ureteroscopy; , simultaneous surgery; , bilateral

邹谨梁波王利洪黄家庆蔡恒. 同期输尿管软镜手术治疗双侧直径2～3cm输尿管上段结石的疗效观察[J]. 临床外科杂志, 2020, 28(7): 683-686.

ZOU Jin, LIANG Bo, WANG Lihong, et al.. The clinical effect of soft ureteroscopy at the same time on bilateral 2～3cm upper ureteral stones[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(7): 683-686.

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