内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石疗效评价  

Evaluation of the efficacy of low pressure irrigation with 4F ureteral catheter combined with holmium laser lithotripsy under ureteroscope in the treatment of incarcerated ureteral calculi

作　　者：连乐林 张育周 赵让加 张俊鑫 黄志雄 UAN Le-lin;ZHANG Yu-zhou;ZHAO Rang-jia(Department of Urology Surgery, Puning Overseas Chinese Hospital,Jieyang 515300, China)

机构地区：[1]普宁华侨医院泌尿外科,515300

出　　处：《中国实用医药》2019年第12期13-15,共3页China Practical Medicine

摘　　要：目的探讨内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石的临床疗效。方法 80例输尿管嵌顿性结石患者,随机分为对照组和观察组,各40例。对照组给予200μm光纤钬激光碎石治疗,观察组给予内置4F输尿管导管低压注水灌洗联合输尿管硬镜200μm光纤钬激光碎石治疗。比较两组患者手术时间、住院时间、并发症发生情况、随访输尿管狭窄情况及结石残留、结石逃逸、术后高热情况。结果观察组手术时间(43.12±3.11)min短于对照组的(56.13±3.36)min,结石残留发生率2.50%、结石逃逸发生率2.50%、术后高热发生率2.50%均低于对照组的25.00%、20.00%、17.50%,差异有统计学意义(P<0.05)。观察组输尿管损伤及术后感染发生率均低于对照组,差异有统计学意义(P<0.05);两组随访输尿管狭窄发生率及住院时间比较差异无统计学意义(P>0.05)。结论内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石的临床疗效确切,手术安全可靠,可有效减少并发症,值得推广应用。Objective To discuss the clinical efficacy of low pressure irrigation with 4 F ureteral catheter combined with holmium laser lithotripsy under ureteroscope in the treatment of incarcerated ureteral calculi.Methods A total of 80 patients with incarcerated ureteral calculi were randomly divided into control group and observation group, with 40 cases in each group. The control group was treated with 200 μm micron holmium laser lithotripsy, and the observation group was treated with low pressure irrigation with 4 F ureteral catheter and 200 μm micron holmium laser lithotripsy with ureteroscope. Comparison were made on operation time, hospitalization time,occurrence of complications, follow-up of ureteral stricture and residual stones, stones escaping and postoperative hyperthermia between the two groups. Results The observation group had shorter operation time as(43.12±3.11)min than(56.13±3.36) min in the control group, incidence of residual stones as 2.50%, incidence of stones escaping as 2.50% and incidence of postoperative hyperthermia as 2.50% than 25.00%, 20.00% and 17.50% in the control group. Their difference was statistically significant(P<0.05). The observation group had lower incidence of ureteral injury and postoperative infection than the control group, and the difference was statistically significant(P<0.05). Both groups had no statistically significant difference in incidence of follow-up of ureteral stricture and hospitalization time(P>0.05). Conclusion Low pressure irrigation with 4 F ureteral catheter combined with holmium laser lithotripsy under ureteroscope is effective, safe and reliable in the treatment of incarcerated ureteral calculi, and can effectively reduce complications. It is worth popularizing and applying.

关 键 词：输尿管导管 钬激光 输尿管嵌顿性结石 低压注水灌洗 

分 类 号：R699.4[医药卫生—泌尿科学]