摘要
目的探讨输尿管硬镜钬激光碎石术中发现结石退回肾盂后,采用改良手术策略进行肾盂内激光碎石的临床效果。方法方便选取2021年1月—2023年12月南京市六合区人民医院泌尿外科收治的53例采用输尿管硬镜钬激光处理输尿管上段结石术中并发结石退回肾盂的患者为研究对象。根据是否应用改良手术策略分为观察组(n=22)和对照组(n=31)。对照组采用常规输尿管硬镜钬激光治疗肾盂内结石,观察组患者采用改良手术策略进行肾盂内激光碎石。对比两组手术总时长,结石清除率以及术后并发症发生率。结果对照组手术总时长为(47.6±5.2)min,稍短于观察组的(52.7±4.8)min,差异有统计学意义(t=3.587,P<0.05)。观察组术后1个月结石清除率为68.18%(15/22),高于对照组的19.35%(6/31),差异有统计学意义(χ^(2)=12.824,P<0.001)。两组严重血尿、发热、肾绞痛、膀胱刺激征发生率对比,差异均无统计学意义(P均>0.05)。结论输尿管硬镜在处理上段结石退回肾盂的情况下,结合碎石技巧、手术体位、术后体外冲击波碎石等,碎石成功率可大大提高,治疗确切有效。
Objective To investigate the clinical effect of improved surgical strategy for intra-pelvic laser lithotripsy after the stones were found to be returned to the renal pelvis during ureteroscopic holmium laser lithotripsy.Methods A total of fifty-three patients with upper ureteral calculi complicated by retraction into the renal pelvis during rigid ureteroscope holmium laser lithotripsy admitted to the Department of Urology of Nanjing City Liuhe District People′s Hospital,from January 2021 to December 2023 were conveniently selected as the research objects.They were divided into the observation group(n=22)and the control group(n=31)according to whether modified surgical strategies were applied.The control group received conventional rigid ureteroscope holmium laser lithotripsy for renal pelvic calculi,while the observation group underwent modified surgical strategies for laser lithotripsy in the renal pelvis.The total op-eration time,stone clearance rate,and incidence of postoperative complications were compared between the two groups.Results The total operation time in the control group was(47.6±5.2)min,slightly shorter than(52.7±4.8)min in the observation group,difference was statistically significant(t=3.587,P<0.05).The stone clearance rate at 1 month after surgery in the observation group was 68.18%(15/22),higher than 19.35%(6/31)in the control group,difference was statistically significant(χ^(2)=12.824,P<0.001).There were no statistically significant differences in the incidence of severe hematuria,fever,renal colic,or bladder irritation symptoms between the two groups(all P>0.05).Conclu-sion When rigid ureteroscope is used to treat upper ureteral calculi retracting into the renal pelvis,combining litho-tripsy techniques,surgical positioning,and postoperative extracorporeal shock wave lithotripsy can significantly im-prove the success rate of lithotripsy,with definite and effective treatment.
作者
熊玉龙
卢振龙
张世清
XIONG Yuong;LU Zhenong;ZHANG Shiqing(Department of Urology,Nanjing City Liuhe District People′s Hospital,Nanjing 211500,Jiangsu,China)
出处
《系统医学》
2025年第12期124-126,130,共4页
Systems Medicine
关键词
经尿道输尿管镜手术
钬激光
肾盂结石
Transurethral ureteroscopic surgery
Holmium laser
Renal pelvic calculi
