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作 者:刘广 汤元杰[2] 胡有根 吴芸冰 宁松毅[2] 钱叶勇 LIU Guang;TANG Yuan-jie;HU You-gen;WU Yun-bing;NING Song-yi;QIAN Ye-yong(The Second Clinical Medical College ,Shanxi Medical University ,Taiyuan 030001 ,Shanxi ,China;Department of Urology,Armed Police Corps Hospital of Jiangsu Province,Yangzhou 225003,Jiangsu,China;Department of Urology,the 309th Hospital of PLA,Beijing 100091,China)
机构地区:[1]山西医科大学第二临床医学院,太原医学硕士研究生030001 [2]武警江苏省总队医院泌尿外科,扬州225003 [3]解放军第三〇九医院泌尿外科,北京100091
出 处:《医学研究生学报》2019年第3期273-277,共5页Journal of Medical Postgraduates
基 金:扬州市"十三五"科教强卫领军人才(创新团队)资助项目(扬卫科教[2018]6号)
摘 要:目的输尿管镜下钬激光与冷刀内切开治疗输尿管狭窄的疗效比较研究较少。文中旨在探讨输尿管镜钬激光与冷刀内切开2种方法在输尿管狭窄治疗中的效果。方法回顾性分析2010年1月至2016年12月武警江苏省总队医院泌尿外科收治的78例接受输尿管狭窄内切开术的患者资料。根据术式不同分为钬激光组(接受输尿管镜钬激光内切开治疗,n=40)和冷刀组(接受输尿管镜冷刀内切开治疗,n=38)。统计分析比较2组临床近期疗效、并发症及远期疗效。结果钬激光组患者术后均有轻度血尿,持续1~2d血尿自行消失,未出现临近器官损伤,无输尿管撕脱、大出血等严重并发症。冷刀组患者术后均有中度血尿,应用止血药2~3d血尿消失。钬激光组手术时间[(35.3±3.8)min]、术后住院天数[(4.0±0.8)d]、术后感染率(7.7%)、治愈率(87.2%)均明显优于冷刀组[(43.4±5.8)min、(5.0±1.4)d、27.3%、57.6%],差异有统计学意义(P<0.05)。结论输尿管镜钬激光治疗输尿管狭窄的临床疗效明显优于冷刀内切开术,具有创伤小、复发率低、并发症少等优点,值得临床推广。Objective The aim of this study was to compared the clinical effect of ureteroscopic holmium laser incision (USHLI)with that of ureteroscopic cold knife incision(USCKI)in the treatment of ureteral stricture. Methods Seventy-eight patients with ureteral stricture underwent USHLI(n = 40)or USCKI(n = 38)in the Armed Police Corps Hospital of Jiangsu Province from January 2010 to December 2016. Comparisons were made between the two surgical strategies in the operation time,postoperative complications,hospital days,short-term effect and long-term effect. Results Mild postoperative hematuria occurred in all the patients of the USHLI group,which lasted 1-2 days before it disappeared without intervention,but with no other severe complications as adjacent organ injury,ureteral avulsion,or massive hemorrhage. Moderate postoperative hematuria was observed in all the patients of the USCKI group,which was stopped at 2-3 days by administration of hemostatics. Compared with USCKI,USHLI achieved a significantly shorter operation time([43.4 ± 5.8]vs[35.3 ± 3.8]min,P < 0.05)and postoperative hospital stay([5.0 ± 1.4]vs[4.0 ± 0.8]d,P < 0.05),lower incidence of postoperative infection(27.3% vs 7.7%,P < 0.05),and higher cure rate(57.6% vs 87.2%,P < 0.05). Conclusion USHLI,with its advantages of less damage,lower recurrence rate and fewer complications,is obviously superior to USCKI in the treatment of ureteral stricture.
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