不同温度生理盐水灌注对经尿道输尿管镜碎石术疗效的影响  

Effect of saline infusion at different temperature on the efficacy of transurethral ureteroscopic lithotripsy

作　　者：李泽宇 刘沛[1] 余泉锋 张冠英 吴春磊[1] LI Ze-yu;LIU Pei;YU Quan-feng;ZHANG Guan-ying;WU Chun-lei(Department of Urology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院泌尿外科二病区

出　　处：《新乡医学院学报》2019年第10期983-985,共3页Journal of Xinxiang Medical University

基　　金：新乡医学院第一附属医院博士科研基金(编号:xyyfy2014BS-003)

摘　　要：目的探讨不同温度生理盐水灌注对经尿道输尿管镜碎石术(URL)疗效的影响。方法选择2017年7月至2018年7月在新乡医学院第一附属医院行经尿道输尿管镜碎石术的169例输尿管结石患者为研究对象,根据术中使用灌注液温度的不同将患者分为对照组(n=89)和观察组(n=80)。对照组患者术中使用22~25℃生理盐水进行灌注,观察组患者使用40℃生理盐水进行灌注。比较2组患者手术时间、术中结石上移率、术后4周结石清除率及并发症发生率。结果观察组患者手术时间短于对照组(P<0.05)。对照组和观察组患者术中结石上移率分别为33.7%(30/89)、12.5%(10/80),观察组患者术中结石上移率显著低于对照组(χ^2=10.488,P<0.05)。术后4周对照组和观察组患者结石清除率分别为71.9%(64/89)、93.8%(75/80),观察组患者结石清除率高于对照组(χ^2=13.764,P<0.05)。观察组和对照组患者术后需再次行URL或体外冲击波碎石术(ESWL)率分别为6.3%(25/89)、28.1%(5/80),观察组患者术后需再次行URL或ESWL率显著低于对照组(χ^2=13.764,P<0.05)。对照组患者发生出血19例(21.3%),进镜失败8例(9.0%),输尿管黏膜撕裂7例(7.9%);观察组患者发生出血16例(20.0%),进镜失败1例(1.3%),输尿管黏膜撕裂2例(2.5%);2组患者出血发生率和输尿管黏膜撕裂率比较差异均无统计学意义(χ^2=0.047、2.405,P>0.05),观察组患者进镜失败率显著低于对照组(χ^2=5.004,P<0.05)。结论URL中使用40℃生理盐水灌注可以提高手术成功率和结石清除率,缩短手术时间,降低进镜失败发生率。Objective To explore the effect of saline infusion at different temperature on the efficacy of transurethral ureteroscopic lithotripsy(URL).Methods A total of 169 patients who underwent URL in the First Affiliated Hospital of Xinxiang Medical University from July 2017 to July 2018 were enrolled.The patients were divided into control group(n=89)and observation group(n=80)according to the temperature of perfusion fluid used during operation.The patients in the control group were perfused with 22-25℃saline,the patients in the observation group were perfused with 40℃saline.The operation time,intraoperative stone upward movement rate,stone clearance rate at 4 weeks after operation and complication rate were compared between the two groups.Results The average operation time of patients in the observation group was shorter than that in the control group(P<0.05).The intraoperative stone upward movement rate of patients in the control group and observation group was 33.7%(30/89)and 12.5%(10/80),respectively;the intraoperative stone upward movement rate of patients in the observation group was significantly lower than that in the control group(χ^2=10.488,P<0.05).The stone clearance rate of patients in the control group and observation group was 71.9%(64/89)and 93.8%(75/80)respectively at 4 weeks after operation;the stone clearance rate of patients in the observation group was higher than that in the control group(χ^2=13.764,P<0.05).The rate of requiring URL or extracorporeal shock wave lithotripsy(ESWL)again after operation in the observation group and the control group was 6.3%(5/80)and 28.1%(25/89)respectively;the rate of requiring URL or ESWL in the observation group was significantly lower than that in the control group(χ^2=13.764,P<0.05).In the control group,there were 19 cases(21.3%)of bleeding,8 cases(9.0%)of failure of entering of endoscopy,7 cases(7.9%)of tear of ureteral mucosa;in the observation group,there were 16 cases(20.0%)of bleeding,1 case(1.3%)of failure of endoscopy,2 cases(2.5%)of tear of uretera

关 键 词：经尿道输尿管镜碎石术 40℃生理盐水 结石清除率 

分 类 号：R693[医药卫生—泌尿科学]