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1.400016 重庆,重庆医科大学附属第一医院泌尿外科
2.400053 重庆,重庆市第十三人民医院泌尿外科
[廖肇洲,E-mail:cqssylzz@sina.comLIAO Zhaozhou, E-mail: cqssylzz@sina.com
收稿:2019-06-19,
修回:2019-08-20,
纸质出版:2019-11-15
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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.
Shengjun LUO, Ye YUAN, Hao HU, et al. Clinical efficacy of negative pressure combined with ureteroscopy and flexible ureteroscopic lithotripsy in treatment of unilateral upper urinary calculi[J]. Journal of Third Military Medical University, 2019, 41(21): 2101-2106.
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.
Shengjun LUO, Ye YUAN, Hao HU, et al. Clinical efficacy of negative pressure combined with ureteroscopy and flexible ureteroscopic lithotripsy in treatment of unilateral upper urinary calculi[J]. Journal of Third Military Medical University, 2019, 41(21): 2101-2106. DOI: 10.16016/j.1000-5404.201906145.
目的
2
对比研究负压组合式输尿管镜(硕通镜)与输尿管软镜钬激光碎石术两种手术方式治疗单侧上尿路结石的有效性和安全性。
方法
2
回顾性分析重庆医科大学附属第一医院和重庆市第十三人民医院2017年12月至2018年12月符合纳入排除标准的211例肾及输尿管上段结石行硕通镜和输尿管软镜碎石术患者的临床资料,其中硕通镜组106例,输尿管软镜组105例。比较两组手术时间、通道鞘置入成功率、术后住院时间、术后感染率、术后1 d结石清除率、术后1个月结石清除率。并按结石最大直径>2 cm和≤2 cm进行亚组分析。
结果
2
两组在通道鞘置入成功率、手术时间、术后1 d结石清除率方面差异有统计学意义(
P
<
0.05);两组术后住院时间、术后感染率、术后1个月结石清除率比较差异无统计学意义(
P
>
0.05)。结石直径>2 cm时,硕通镜组术后1 d、1个月清石率为81.82%,均显著高于软镜组(
P
<
0.05),两组手术时间差异无统计学意义;结石直径≤2 cm时,硕通镜组在术后1 d、1个月清石率优于软镜组,但手术时间长于软镜组,差异均有统计学意义(
P
<
0.05)。
结论
2
硕通镜和输尿管软镜治疗单侧上尿路结石均安全有效,硕通镜在治疗直径>2 cm的结石时更具优势,但一期手术成功率较输尿管软镜低。
Objective
2
To evaluate the efficacy and safety of negative pressure combined with ureteroscopy (NPUR) with holmium laser in the treatment of unilateral upper urinary tract calculi in comparison with flexible ureteroscopy (FURS).
Methods
2
The clinical data were retrospectively analyzed for 211 patients of unilateral renal and proximal urinary calculi who received NPUR or FURS in the First Affiliated Hospital of Chongqing Medical University and the Thirteenth People's Hospital of Chongqing between December 2017 and December 2018. Of these patients
106 received NPUR and the other 105 underwent FURS. Operation time
successful rate of ureteral access sheath placement
postoperative length of hospital stay
postoperative infection rate
stone free rate (SFR) at 1 d and 1 month after operation were compared between the 2 groups. According to the size of calculi
the 2 groups were divided 2 subgroups (> 2 cm and ≤2 cm) in order to make further analysis.
Results
2
There were significant differences in successful rate of ureteral access sheath placement
operation time and SFR at 1 d after operation (
P
<
0.05); No significant differences were found in postoperative length of hospital stay
postoperative infection rate
and SFR at 1 month after operation (
P
>
0.05). When the size of calculi was
>
2 cm
the SFR was better in the NPUR group than the FURS group. But no difference was seen in the operation time.
Conclusion
2
NPUR and FURS are safe and effective in treatment for unilateral upper urinary tract calculi. NPUR is superior in treating larger (> 2 cm) stones
but the successful rate of same-session is lower than FURS.
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