摘要
目的 探讨负压吸引软镜鞘在基层医院提高输尿管软镜手术效率,减少患者总体医疗支出的可行性。方法回顾性分析2023年1月至2024年6月于安徽医科大学第一附属医院岳西医院接受输尿管软镜手术治疗上尿路结石的患者58例患者的临床资料,根据手术日期排列分为负压鞘组与常规鞘组,常规鞘组纳入2023年1月至2023年8月的25例上尿路结石患者,采用常规无负压鞘;负压鞘组纳入2023年9月至2024年6月使用负压吸引鞘完成RIRS的33例上尿路结石患者。比较两组手术时间、术中出血、术后住院时间、术后2 d及4周清石率、手术并发症、留置输尿管支架时间等指标。结果 负压鞘组输尿管支架留置时间、并发症发生率明显低于常规鞘组,差异有统计学意义(P<0.05);负压鞘组术中出血量、术后2 d清石率结果明显高于常规鞘组,差异有统计学意义(P<0.05);两组手术时间、术后住院时间、术后4周清石率方面比较,差异无统计学意义(P>0.05)。结论 末端可弯曲负压吸引鞘较常规鞘更加安全有效,显著提高软镜术后清石率,减少输尿管支架留置时间,且减少手术耗材支出,改善患者就医体验,减少总医疗费用。
Objective To investigate the feasibility of using a flexible endoscope sheath with negative pressure suction to improve the efficiency of flexible ureteroscopy and reduce overall medical expenditure for patients in primary hospitals.Methods A retrospective analysis was conducted on 58 patients who underwent flexible ureteroscopy for upper urinary tract stones in our hospital from January 2023 to June 2024.Among them,33 patients were treated with a flexible endoscope sheath with negative pressure suction at the tip(negative pressure sheath group),and 25 patients were treated with a conventional sheath without negative pressure suction(conventional sheath group).The operation duration,intraoperative bleeding,postoperative hospital stay,stone clearance rates at 2 days and 4 weeks after surgery,surgical complications,and duration of ureteral stent placement were compared between the two groups.Results In the negative pressure sheath group,the duration of ureteral stent placement and the incidence of complications were significantly lower than those in the conventional sheath group(P<0.05).The intraoperative blood loss and stone clearance rate at 2 days after surgery were significantly higher in the negative pressure sheath group than in the conventional sheath group(P<O.05).However,there were no statistically significant differences in operation duration,postoperative hospital stay,and stone clearance rate at 4 weeks after surgery between the two groups(P>0.05).Conclusion Compared with conventional sheaths,the flexible endoscope sheath with negative pressure suction at the tip is safe and effective,showing significant advantages in improving the stone clearance rate and duration of ureteral stent placement after flexible ureteroscopy.It also reduces the use of surgical consumables,enhances the overall patients experience,and lowers total medical costs.
作者
储刚
石瑛
肖文
海波
王加志
储逸
Chu Gang;Shi Ying;Xiao Wen;Hai Bo;Wang Jiazhi;Chu Yi(Department of Urology,Yue Xi Hospital,First Affiliated Hospital of Anhui Medical University,Anqing,Anhui 246600,China;Department of Urology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430000,China)
出处
《泌尿外科杂志(电子版)》
2025年第4期43-47,共5页
Journal of Urology for Clinicians(Electronic Version)
基金
安徽省安庆市卫生健康委科研课题卫宣教[2022]298号。
