摘要
目的探讨输尿管扩张鞘(ureteral access sheath,UAS)在输尿管软镜(flexible ureteroscopy,fURS)治疗1~2cm肾结石中的应用价值。方法回顾性分析2015年9月~2017年9月在苏州大学附属第一医院行fURS手术治疗的190例1~2cm肾结石患者的临床资料。UAS(大小F14/12)组133例,年龄22~76岁,平均(52±12)岁,男85例,女48例;结石长径平均(1.6±0.2)cm;肾盂、中盏及上盏结石共90例,下盏结石28例,多发结石15例。未使用UAS组57例,年龄16~83岁,平均(50±15)岁,男35例,女22例;结石长径平均(1.5±0.1)cm;肾盂、中盏及上盏结石共38例,下盏结石12例,多发结石7例。对2组患者手术时间、手术并发症和一期结石清除率进行比较分析。结果 2组在年龄、性别比例、结石大小和结石分布上差异均无统计学意义。2组手术时间分别为(80±25)min和(75±19)min(P>0.05);术中输尿管损伤发生率分别为6.0%(8/133)和3.5%(2/57)(P>0.05);术后发热发生率分别为9.8%(13/133)和21.1%(12/57)(P=0.035);术后4周随访结石清除率分别为81.2%(108/133)和75.4%(43/57)(P>0.05)。结论对于长径为1~2cm的肾结石,fURS术中使用和不使用UAS的术后结石清除率无明显差异,使用UAS不会增加输尿管损伤的发生率,但是术后发热的发生率明显下降。
Objective To evaluate the application value of ureteral access sheath(UAS)in treating kidney stones in size 1 to2 cm with flexible ureteroscopy(fURS).Methods Data on a total of 190 consecutive patients who underwent fURS for kidney stone in size 1 to 2 cm between September 2015 and September 2017 were retrospectively collected.In the UAS group,there were 85 males and 48 females,mean age was(52±12)years(range 22-76 years),mean stone size was(1.6±0.2)cm,and stone location was in the pelvis,upper pole and middle pole in 90 patients,lower pole in 28 and multiple in 15.In non-UAS group,there were 35 males and 22 females,mean age was(50±15)years(range 16-83 years),mean stone size was(1.5±0.1)cm,and stone location was in the pelvis,upper pole and middle pole in 38,lower pole in 12 and multiple in 7.The operation time,complication and stone-free rate were compared between UAS group and non-UAS group.Results The age,sex ratio,stone size and stone location did not differ in two groups.The mean operation time were(80±25)min and(75±19)min(P>0.05),the incidence of ureteral damage was 6.0%(8/133)and 3.5%(2/57)(P>0.05),the incidence of postoperative fever was 9.8%(13/133)and 21.1%(12/57)(P=0.035),and the stone-free rate at 4 weeks postoperatively was 81.2%(108/133)and 75.4%(43/57)(P>0.05),respectively in the two groups.Conclusion This study demonstrates there is no significant difference in stonefree rate whether a UAS is used or not in the treatment with fURS for kidney stones in size 1 to 2 cm.Meanwhile,UAS does not increase the risk of ureteral injury,but decreases incidence of fever postoperatively.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2017年第6期697-699,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
肾结石
输尿管软镜
输尿管扩张鞘
kidney calculi
flexible ureteroscopy
ureteral access sheath
