输尿管软镜治疗上尿路结石的疗效分析  

Curative analysis of flexible ureter in treatment of upper urinary tract calculi

作　　者：朱斌[1] 潘卫兵[1] 谢礼仁 张遂兵[1] 罗林斌 盘昌力 张磊磊[1] 

机构地区：[1]深圳市坪山新区人民医院泌尿外科,广东深圳518118

出　　处：《中国医药科学》2016年第22期172-174,共3页China Medicine And Pharmacy

摘　　要：目的探讨输尿管软镜治疗上尿路结石的临床疗效。方法选择上尿路结石154例,以随机数字表法分组,观察组（77例）采用输尿管软镜联合钬激光碎石术治疗,对照组（77例）实施经皮肾镜取石术。结果与对照组比较,观察组的住院时间较短,且术中出血量少,组间对比存在显著差异（P〈0.05）,而两组手术时间比较,无显著性差异（P〉0.05）。观察组总碎石成功率89.6%（69/77）,对照组为83.1%（64/77）,两组总结石清除率无显著差异（χ2=1.378,P=0.174）。两组均无输尿管穿孔、粘膜撕脱、大出血、肾脏严重损伤等严重并发症,观察组患者术后感染发热等并发症发生率为12.99%,与对照组的16.88%相比,无显著差异（χ~2=0.460,P=0.326）。结论把握好手术适应症、做到充分的术前准备以及精细的手术操作可以使得输尿管软镜治疗上尿路结石取得良好的效果,以及较高的安全性。Objective To explore the clinical effects of flexible ureter in treatment of upper urinary tract calculi.Methods 154 cases of upper urinary calculi were selected and grouped by random digits table method.Patients in observation group（77 cases） were treated with flexible ureter combined with holmium laser lithotripsy,and patients in control group（77 cases） were treated with percutaneous renal lithotripsy.Results Compared with the control group,the hospitalization time in observation group was shorter,and the amount of bleeding during operation was less,there was significant difference between the two groups（P〈0.05）.There was no significant difference in the operation time between the two groups（P〉0.05）.The success rate in observation group was 89.6%（69/77）,while the control group was 77.9%（69/77）,and there was significant difference between the two groups（χ~2=3.868,P=0.039）.There were no serious complications such as ureteral perforation,mucosal avulsion,massive hemorrhage,severe renal injury,and so on,and the incidence rate of complications such as fever after the operation was 12.99%,compared with the control group of 16.88%,there was no significant difference（χ2=0.460,P=0.326）.Conclusion Compared with percutaneous nephrolithotomy,ureteroscopy and Holium laser lithotripsy for upper urinary tract calculi has good curative effect,safety and other advantages,but it needs the indications of surgery,sufficient preoperative preparation and meticulous surgical procedures.

关 键 词：输尿管软镜 钬激光 碎石 上尿路结石 尿脓毒血症 

分 类 号：R699[医药卫生—泌尿科学]