摘要
目的探讨使用输尿管软镜联合末端可弯曲负压吸引鞘一期处理合并泌尿系感染的输尿管上段结石的可行性及安全性。方法采用回顾性队列研究,选择我科2022年9月~2024年8月收治的长径≤10 mm单侧输尿管上段结石合并泌尿系感染的患者,研究组纳入一期使用输尿管软镜联合末端可弯曲负压吸引鞘治疗的58例,对照组先一期留置输尿管内支架管,1个月后再行二期手术,术式与研究组相同,共60例。比较两组患者的感染相关指标、术后1月清石率及并发症发生率。结果患者均顺利完成手术。研究组平均手术时间(36.50±15.50)min,短于对照组的(42.61±5.06)min(P=0.006);研究组总住院时间为(8.00±1.41)d,短于对照组的(10.09±0.46)d(P<0.001);研究组总并发症发生率为3.45%,与对照组1.67%比较无统计学差异(P>0.05);研究组患者术后1月清石率94.83%(55/58),与对照组的95%(57/60)比较无统计学差异(P>0.05)。结论在输尿管上段结石合并泌尿系感染的患者中,对于抗生素及支持治疗反应良好者,采用输尿管软镜联合末端可弯曲负压吸引鞘一期处理是可行的,具有较高的清石率和安全性。
Objective To explore the feasibility and safety of one-stage treatment of upper ureteral cal-culi complicated by urinary tract infection using flexible ureteroscopy with a deflectable-tip vacuum-assisted ac-cess sheath.Methods A retrospective cohort study was conducted,enrolling patients with unilateral upper ureteral calculi(≤10 mm)complicated with urinary tract infection who were admitted to our department from September 2022 to August 2024.The study group included 58 patients who underwent one-stage treatment of flexible ureteroscopy with a deflectable-tip vacuum-assisted access sheath,while the control group included 60 patients who received indwelling ureteral stents in the first stage and then underwent the same surgical procedure in the second stage one month later.Infection-related indicators,stone-free rate at 1 month after surgery,and the complication rates were compared between the two groups.Results All patients successfully completed the surgery.The average operation time in the study group was(36.50±15.50)minutes,which was significantly shorter than(42.61±5.06)minutes of the control group(P=0.006).The total hospitalization time in the study group was(8.00±1.41)days,significantly shorter than(10.09±0.46)days of the control group(P<0.001).The total complication rate in the study group was 3.45%,showing no statistically significant difference compared with 1.67%of the control group(P>0.05).The stone-free rate at 1 month after surgery was 94.83%(55/58)in the study group,which was not statistically different from 95%(57/60)in the control group(P>0.05).Conclusion For patients with ureteral calculi complicated with urinary tract infection who respond well to antibiotics,one-stage treatment using flexible ureteroscopy with a deflectable-tip vacuum-assisted access sheath is feasible,with a high stone-free rate and safety.
作者
谭谈
龙蠡
唐汇龙
杨华伟
谢海平
刘起立
狄奇
TAN Tan;LONG Li;TANG Huilong;YANG Huawei;XIE Haiping;LIU Qili;DI Qi(Department of Urology,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China)
出处
《中国现代手术学杂志》
2025年第3期229-233,共5页
Chinese Journal of Modern Operative Surgery
关键词
输尿管上段结石
感染
末端可弯式输尿管软镜鞘
负压系统
upper ureteral stones
infection
flexible distal-tip ureteral access sheath
negative pressure system
