不同手术时机对输尿管镜下钬激光碎石术的效果比较  

Comparison of the different opportunities for ureterscopic holmium laser lithotripsy

作　　者：周睿[1] 朱劲松[1] 戴宇红[1] 陈志洁[1] 鲍彤[1] 杨凯[1] 

机构地区：[1]安徽医科大学安庆附属医院泌尿外科,246001

出　　处：《中华腔镜泌尿外科杂志（电子版）》2014年第5期38-42,共5页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较不同手术时机对输尿管镜下钬激光碎石治疗输尿管中下段结石的影响。方法回顾性分析自2009年3月至2013年3月在我院行输尿管镜下钬激光碎石术治疗输尿管中下段结石的77例患者的临床资料,其中26例单侧,3例双侧在首次肾绞痛2周内行输尿管镜钬激光碎石术为A组,45例单侧,3例双侧在首次肾绞痛2周以后行输尿管镜钬激光碎石术为B组。对两组患者的术前感染发生率、输尿管息肉的发生率、手术时间及术后双J管留置时间进行比较分析。结果两组患者的术前尿常规提示感染发生率有统计学差异(P<0.05),但尿培养则无明显统计学差异。两组输尿管息肉的发生率有统计学差异(P<0.05)。两组患者手术时间有统计学差异(P<0.05);两组患者的术后早期拔除双J管率有统计学差异(P<0.05)。结论在肾绞痛发作2周内进行手术,可减少输尿管息肉的发生、降低泌尿道感染发生率、降低手术难度、减少手术时间、减少留置双J管的时间。Objective To compare the effects of the different opportunities for ureterscopic holmium laser lithotripsy in the treatment of ureteral calculus.Methods The data of 77 patients treatment with ureteroscopic holmium：YAG laser lithotripsy from March 2009 to March 2013 at the department of Urology in Anqing municipal Hospital,including group A（26 unilateral cases and 3 bilateral cases in early operation group which were treated in two weeks after presenting with their first episode of ureteric colic）and group B （45 unilateral cases and 3 bilateral cases in delayed operation which were treated beyond two weeks） were analyzed retrospe ctively.The variables such as infection,operative time,ureter polyp and double J tube indwelling time.Results The preoperative infection rate which was showed by urine analysis and the occurrence of ureter polyp had significant difference between the two groups （P〈0.05）.There were no significant differences in urine culture between the two groups.The significant differences were identified between the two groups in the operation time （P〈0.05）.The double J tube indwelling time of early operation time was shorter than the other group （P〈0.05）.Conclusions The early treatment ofureteral calculi with the ureteroscopic holmium laser lithotripsy will decrease the urinary infection rate,reduce the incidence of polyps,shorten the operation and the double J tube indwelling time.

关 键 词：肾绞痛 钬激光碎石术 输尿管结石 输尿管镜 

分 类 号：R699.4[医药卫生—泌尿科学]