摘要
目的探讨可弯曲负压吸引鞘联合一次性输尿管软镜治疗上尿路结石的疗效。方法回顾性分析2021年9月~2022年9月我院应用F_(7.5)一次性输尿管软镜治疗上尿路结石,其中采用可弯曲负压吸引鞘97例(可弯曲鞘组),常规鞘86例(常规鞘组),比较2组围手术期及清石率等指标。结果可弯曲鞘组手术时间(101.8±11.4)min,显著长于常规鞘组(82.2±11.8)min(t=11.454,P=0.000);术后血红蛋白下降值(6.6±2.4)g/L,显著高于常规鞘组(3.7±1.6)g/L(t=9.288,P=0.000);住院费用(22329.5±1389.5)元,显著低于常规鞘组(24763.9±1140.8)元(t=-12.854,P=0.000);术后3 d清石率85.6%(83/97),显著高于常规鞘组72.1%(62/86,χ^(2)=5.030,P=0.025);术后体外冲击波碎石5例,显著少于常规鞘组12例(χ^(2)=4.188,P=0.041)。2组后1个月清石率比较差异无统计学意义(χ^(2)=0.036,P=0.850)。结论可弯曲负压吸引鞘联合一次性输尿管软镜碎石术提高术后近期清石率,增加操作的难度与时间,增加出血的风险,建议有一定软镜手术经验的医师进行操作。
Objective To explore the effectiveness of flexible negative pressure ureteral access sheath combined with disposable flexible ureteroscope in the treatment of upper urinary tract calculi.Methods A retrospective analysis was made on patients treated with F_(7.5)disposable flexible ureteroscope from September 2021 to September 2022,among which 97 cases were combined with flexible negative pressure ureteral access sheaths(flexible sheath group)and 86 cases with conventional sheaths(conventional sheath group).The perioperative parameters and stone clearance rate between the two groups were compared.Results The duration of the operation was significantly longer in the flexible sheath group[(101.8±11.4)min]than that in the conventional sheath group[(82.2±11.8)min,t=11.454,P=0.000].The postoperative hemoglobin decrease was significantly more in the flexible sheath group[(6.6±2.4)g/L]than that in the conventional sheath group[(3.7±1.6)g/L,t=9.288,P=0.000].The hospitalization expenses were significantly lower in the flexible sheath group[(22329.5±1389.5)yuan]than those in the conventional sheath group[(24763.9±1140.8)yuan,t=-12.854,P=0.000].The stone removal rate at 3 days after surgery was significantly higher in the flexible sheath group[85.6%(83/97)]than that in the conventional sheath group[72.1%(62/86),χ^(2)=5.030,P=0.025].The extracorporeal shock wave lithotripsy after surgery was given in 5 cases in the flexible sheath group,which was significantly lower than that in the conventional sheath group(12 cases,χ^(2)=4.188,P=0.041).There was no significant difference between the two groups in stone removal rate at 1 month after surgery(χ^(2)=0.036,P=0.850).Conclusions The application of flexible negative pressure ureteral access sheath combined with disposable flexible ureteroscope can improve the short-term postoperative stone clearance rate,but increase the difficulty and time of the operation,and increase the risk of bleeding.It is recommended to be carried out by doctors with strong experience in flexible ureteroscope.
作者
林剑峰
叶志彬
涂建平
梁福律
胡力仁
郭昭建
范先明
Lin Jianfeng;Ye Zhibin;Tu Jianping(Department of Urology,Xiamen Third Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Xiamen 361100,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第9期652-656,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
上尿路结石
可弯曲负压吸引鞘
输尿管软镜碎石术
Upper urinary tract calculi
Flexible negative pressure ureteral access sheath
Flexible ureteroscope lithotripsy
