负压组合式输尿管镜与输尿管软镜钬激光碎石术治疗单侧上尿路结石的对比研究

doi:10.3760/cma.j.issn.1007-1245.2021.06.021

国际医药卫生导报 ›› 2021, Vol. 27 ›› Issue (6): 871-874.DOI: 10.3760/cma.j.issn.1007-1245.2021.06.021

负压组合式输尿管镜与输尿管软镜钬激光碎石术治疗单侧上尿路结石的对比研究

吕文伟, 魏澎涛, 张寒, 康延杰, 杨凌博, 刘红燕, 尚亚峰, 孙建涛

郑州大学附属洛阳中心医院泌尿外科,河南 471000

收稿日期:2020-09-01 出版日期:2021-03-15 发布日期:2021-04-15
通讯作者: 吕文伟,Email:dewilv@sina.com

Comparative study of negative pressure combined ureteroscopic lithotripsy and flexible ureteroscopy combined holmium laser lithotripsy in the treatment of unilateral upper urinary tract calculi

Lyu Wenwei, Wei Pengtao, Zhang Han, Kang Yanjie, Yang Lingbo, Liu Hongyan, Shang Yafeng, Sun Jiantao

Department of Urology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471000, China

Received:2020-09-01 Online:2021-03-15 Published:2021-04-15
Contact: Lyu Wenwei, Email: dewilv@sina.com

摘要/Abstract

摘要： 目的比较负压组合式输尿管镜与输尿管软镜钬激光碎石术(f-URS)治疗单侧上尿路结石的临床效果。方法选取于2018年6月至2020年6月在本院住院治疗的单侧上尿路结石患者80例,随机分为对照组和研究组,每组40例,对照组予以f-URS治疗,研究组予以负压组合式输尿管镜钬激光碎石术治疗。比较两组术后的住院天数、手术时间、结石清除率以及治疗前后的血红蛋白(Hb)、血肌酐(Cr)水平,统计两组治疗后的并发症发生率。结果研究组的手术时间长于对照组[(54.12±6.25)min比(35.41±5.73)min](P<0.05),术后24 h的结石清除率高于对照组[90.0%(36/40)比62.5%(25/40)](P<0.05),总并发症发生率低于对照组[5.0%(2/40)比25.0%(10/40)](P<0.05);两组的住院天数和术后30 d的结石清除率差异均无统计学意义(均P>0.05)。治疗后两组的Hb均低于治疗前(均P<0.05),组间比较差异无统计学意义(P>0.05);两组的Cr治疗前后及组间比较差异均无统计学意义(均P>0.05)。结论对于单侧上尿路结石的患者,负压组合式输尿管镜与f-URS都是有效的治疗方法,与f-URS比较,负压组合式输尿管镜钬激光碎石术可避免更多的并发症,且对于直径>20 mm结石的治疗效果更明显。

关键词: 单侧上尿路结石, 负压组合式输尿管镜, 输尿管软镜钬激光碎石术, 临床效果

Abstract: Objective To compare the clinical curative effect of negative pressure combined ureteroscopic lithotripsy and flexible ureteroscopy combined holmium laser lithotripsy (f-URS) on unilateral upper urinary tract calculi. Methods Eighty patients with unilateral upper urinary tract calculi who were treated in our hospital between June 2018 and June 2020 were enrolled. They were randomly divided into control group and study group, 40 cases in each group. The control group was treated with f-URS, while the study group was treated with negative pressure combined ureteroscopic lithotripsy combined holmium laser lithotripsy. The hospitalization time, operation time, stone clearance rate, as well as levels of hemoglobin (Hb) and serum creatinine (Cr) before and after treatment were compared between the two groups. The incidence of complications after treatment in both groups was statistically analyzed. Results The operation time in the study group was longer than that in the control group [(54.12±6.25) min vs.(35.41±5.73) min] (P<0.05), the stone clearance rate within 24 h after surgery was higher than that in the control group [90.0% (36/40) vs.62.5% (25/40)] (P<0.05), and the total incidence of complications was lower than that in the control group [5.0% (2/40) vs.25.0% (10/40)] (P<0.05). There were no statistically significant differences in hospitalization time and stone clearance rate within 30 d after surgery between the two groups (both P>0.05). After treatment, Hb in both groups decreased (both P<0.05), and there was no statistically significant difference in Hb between the two groups (P>0.05). There was no statistically significant difference in Cr before and after treatment, as well as between the two groups (all P>0.05). Conclusions For patients with unilateral upper urinary tract calculi, both negative pressure combined ureteroscopic lithotripsy and f-URS are effective treatment methods. Compared with f-URS, negative pressure combined ureteroscopic lithotripsy can avoid more complications, with more significantly curative effect on the stones with diameter longer than 20 mm.

Key words: Unilateral upper urinary tract calculi, Negative pressure combined ureteroscopic lithotripsy, Flexible ureteroscopy combined holmium laser lithotripsy, Clinical effect

吕文伟, 魏澎涛, 张寒, 康延杰, 杨凌博, 刘红燕, 尚亚峰, 孙建涛. 负压组合式输尿管镜与输尿管软镜钬激光碎石术治疗单侧上尿路结石的对比研究[J]. 国际医药卫生导报, 2021, 27(6): 871-874.

Lyu Wenwei, Wei Pengtao, Zhang Han, Kang Yanjie, Yang Lingbo, Liu Hongyan, Shang Yafeng, Sun Jiantao. Comparative study of negative pressure combined ureteroscopic lithotripsy and flexible ureteroscopy combined holmium laser lithotripsy in the treatment of unilateral upper urinary tract calculi[J]. International Medicine and Health Guidance News, 2021, 27(6): 871-874.

参考文献

[1] 乐克平,顾懿宁,刘春林,等.输尿管硬镜联合输尿管软镜钬激光碎石术治疗复杂上尿路结石疗效及术后生活质量研究[J].河北医学,2016,22(12):1985-1986,1987. DOI:10.3969/j.issn.1006-6233.2016.12.019.
[2] 张慧明,乔庆东,王新丽.输尿管软镜钬激光碎石术治疗上尿路结石的体会[J].中国内镜杂志,2016,22(4):104-106. DOI:10.3969/j.issn.1007-1989.2016.04.025.
[3] 潘东升,赵兴华,许长宝,等.硕通镜在治疗上尿路结石梗阻性脓肾中的应用[J].临床与病理杂志,2018,38(12):2616-2620. DOI:10.3978/j.issn.2095-6959.2018.12.015.
[4] 彭洁敏,余向艳,吕才模,等.23例飞行人员上尿路结石的早期诊断、治疗及愈后评价[J].中华航空航天医学杂志,2002,13(4):258-259. DOI:10.3760/cma.j.issn.1007- 6239.2002.04.015.
[5] 那彦群,叶章群,孙颖浩,等. 中国泌尿外科疾病诊断治疗指南手册:2014版[M].北京:人民卫生出版社,2014:129-165.
[6] 刘英,王志勇,徐辉,等.承德地区尿路结石成分分析及健康护理指导对尿石症患者的影响[J].中国煤炭工业医学杂志,2017,20(5):591-593. DOI:10.11723/mtgyyx 1007-9564 201705021.
[7] 曾国华,麦赞林,夏术阶,等.中国成年人群尿石症患病率横断面调查[J].中华泌尿外科杂志,2015,36(7):528-532. DOI:10.3760/cma.j.issn.1000-6702.2015.07.014.
[8] 马海,李杨,周文奇,等.输尿管软镜钬激光碎石术治疗上尿路结石(附86例报告)[J].中国微创外科杂志,2017,17(6):565-567. DOI:10.3969/j.issn.1009-6604.2017.06.025.
[9] 王贻兵,王侠.复杂性输尿管上段结石治疗进展综述[J].实用临床医药杂志,2019,23(7):130-132. DOI:10.7619/jcmp.201907035.
[10] 何灼彬,黄安余,卢凤英.硕通镜联合输尿管软镜与经皮肾镜联合输尿管软镜治疗复杂性肾结石的临床比较观察[J].山西医药杂志,2018,47(16):1923-1927. DOI:10.3969/j.issn.0253-9926.2018.16.021.
[11] 熊波波,张劲松,王海峰,等.硕通镜联合钬激光治疗肾盂结石的临床疗效[J].昆明医科大学学报,2019,40(4):66-70. DOI:10.3969/j.issn.1003-4706.2019.04.014.
[12] 王树声,翁湘涛,周均洪,等.硕通镜治疗上尿路结石的有效性与安全性[J].中华泌尿外科杂志,2017,38(9):671-674. DOI:10.3760/cma.j.issn.1000-6702.2017.09.008.
[13] 罗生军,袁野,胡豪,等.硕通镜与输尿管软镜治疗单侧上尿路结石的效果分析[J].第三军医大学学报,2019,41(21):2101-2106. DOI:10.16016/j.1000-5404.201906145.
[14] 顾燕,章璟,杨佳伟.体外冲击波碎石与输尿管软镜治疗肾结石对肾功能影响的研究[J].国际泌尿系统杂志,2017,37(1):35-38. DOI:10.3760/cma.j.issn.1673-4416. 2017.01.011.

负压组合式输尿管镜与输尿管软镜钬激光碎石术治疗单侧上尿路结石的对比研究

Comparative study of negative pressure combined ureteroscopic lithotripsy and flexible ureteroscopy combined holmium laser lithotripsy in the treatment of unilateral upper urinary tract calculi

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics