输尿管软镜与微通道经皮肾镜碎石术治疗输尿管上段结石的疗效对比

doi:10.3969/j.issn.1005-6483.2020.10.022

摘要/Abstract

摘要： 目的通过对输尿管软镜与微通道经皮肾镜碎石术治疗输尿管上段结石的疗效比较，分析两种术式的安全性及有效性。
方法 2017年6月～2020年3月收治的输尿管上段结石病人86例，按数字奇偶法分为输尿管软镜组和经皮肾镜组两组，每组各43例，比较两组的临床疗效。
结果两组病人无穿刺及置镜失败者，输尿管软镜组病人术后住院时间为(2.73±0.55)天，术中失血量为(4.13±1.29)ml，经皮肾镜组分别为(5.19±0.79)天、(13.65±2.22)ml，两组比较差异有统计学意义(P<0.05)；输尿管软镜组病人舒适度评分为(3.76±0.53)分，经皮肾镜组为(2.82±0.51)分，疼痛VAS评分分别为(0.92±0.63)分和(2.07±0.96)分，两组比较差异有统计学意义(P<0.05)，经皮肾镜组术后即刻清石率为97.67%,输尿管软镜组为93.02%，两组1个月后清石率均为100%，两组间比较差异无统计学意义，输尿管软镜组术后发热1例，经抗感染治疗好转，无中转手术，微通道经皮肾镜组无需要介入治疗的出血及严重感染并发症。
结论两组远期清石率相当，输尿管软镜治疗输尿管上段结石可使病人术后住院时间显著缩短，减少术中失血量，提升舒适度，降低疼痛感。

关键词: 输尿管软镜, 微通道经皮肾镜碎石术, 输尿管上段结石

Abstract: Objective To investigate the clinical effect of flexible ureteroscopy and microchannel percutaneous nephrolithotripsy in the treatment of upper ureteral calculi.
Methods A total of 86 cases of upper ureteral calculi admitted to our hospital from June 2017 to March 2020 were grouped by digital odd-even method.The ureteroscope group(43 cases):the ureteroscope was selected to complete the treatment of upper ureteral calculi.In the percutaneous nephrolithotomy group(43 cases):microchannel percutaneous nephrolithotripsy was selected to complete the treatment of upper ureteral calculi.Postoperative hospital stay,intraoperative blood loss,comfort score and VAS score were compared between groups.
Results The postoperative hospitalization days(2.73±0.55) d and intraoperative blood loss(4.13±1.29) ml of patients with upper ureteral calculi in the flexible ureteroscope group were shorter than those in the percutaneous nephrolithotomy group(5.19±0.79) d and(13.65±2.22) ml,respectively(P<0.05).The comfort score(3.76±0.53) and the VAS score(0.92±0.63) of the patients with upper ureteral calculi in the flexible ureteroscope group were significantly higher than and lower than that in the percutaneous nephrolithotomy group(2.82±0.51) and(2.07±0.96),respectively(P<0.05).There was no statistical significance between the two groups.In the flexible ureteroscope group,there was Icase of postoperative fever,which was improved after anti-infection treatment,and there was no transfer operation,In the microchannel percutaneous nephroscopy group,there was no bleeding requiring intervention or serious infection complications.
Conclusion The long-term stone clearing rates of the two groups were similarThe effective application of ureteroscope can significantly shorten the postoperative hospital stay of patients with upper ureteral calculi,effectively reduce intraoperative blood loss,improve comfort and reduce pain.

Key words: flexible ureteroscope, microchannel percutaneous nephrolithotripsy, upper ureteral calculi

袁勇鞠文. 输尿管软镜与微通道经皮肾镜碎石术治疗输尿管上段结石的疗效对比[J]. 临床外科杂志, 2020, 28(10): 974-976.

YUAN Yong, JU Wen.. Comparison of the effects of flexible ureteroscopy and microchannel percutaneous nephrolithotripsy in the treatment of upper ureteral calculi[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(10): 974-976.

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