快速康复外科干预对输尿管中上段结石合并肾积水患者输尿管软镜取石术后预后的影响  

Effect of fast track surgery intervention on the prognosis of patients with middle and upper ureteral calculi combined with hydronephrosis after flexible ureteroscopic lithotomy

作　　者：夏少翠 张家翠 王莹 Xia Shaocui;Zhang Jiacui;Wang Ying(Department of Urology,Chuzhou Clinical College of Anhui Medical University,the First People's Hospital of Chuzhou,Anhui,Chuzhou 239000,China)

机构地区：[1]安徽医科大学滁州临床学院滁州市第一人民医院泌尿外科,安徽滁州239000

出　　处：《中国医学前沿杂志（电子版）》2020年第8期108-112,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2018年安徽省医学会急诊临床研究项目(Ky2018003)。

摘　　要：目的分析快速康复外科(fast track surgery,FTS)干预对输尿管中上段结石合并肾积水患者输尿管软镜取石术后预后的影响。方法选取2017年3月至2020年3月滁州市第一人民医院收治的120例输尿管中上段结石合并肾积水患者为研究对象,按照随机数字表法将其分为观察组和对照组,每组各60例。所有患者均行输尿管软镜取石术治疗,对照组患者围术期接受常规康复干预,观察组患者围术期接受FTS干预。比较两组患者手术情况、手术效果、术后恢复情况、术后并发症发生情况和生活质量评分。结果观察组患者手术时间、术后导尿管留置时间、住院天数均显著短于对照组(均P<0.05),术中出血量显著少于对照组(P<0.05),术后首次进食时间和下床活动时间均显著早于对照组(均P<0.05),住院费用和术后并发症发生率均显著低于对照组(均P<0.05)。两组患者术后4周结石清除率比较差异无统计学意义(P>0.05)。两组患者术后4周角色限制、生理功能、社会功能和总体健康评分均显著高于本组术前1 d(均P<0.05),观察组患者术后4周上述评分均显著高于对照组(均P<0.05)。结论输尿管中上段结石合并肾积水患者输尿管软镜取石术的围术期应用FTS干预,能够缩短手术时间,促进患者术后恢复,提高手术安全性,改善患者生活质量。Objective To analyze the effect of fast track surgery(FTS)intervention on the prognosis of patients with middle and upper ureteral calculi combined with hydronephrosis after flexible ureteroscopic lithotomy.Method From March 2017 to March 2020,120 patients with middle and upper ureteral calculi combined with hydronephrosis in the First People's Hospital of Chuzhou were selected as the research objects.According to the random number table method,patients were divided into observation group and control group,with 60 cases in each group.All patients were treated with flexible ureteroscopy lithotomy.Patients in control group were given routine rehabilitation intervention during the perioperative period,and patients in observation group were given FTS intervention during the perioperative period.The operation condition,operation effect,postoperative recovery,postoperative complications and quality of life score were compared between the two groups.Result The operation time,postoperative catheter indwelling time and hospital day of observation group were significantly shorter than those of control group(all P<0.05),the intraoperative blood loss was significantly less than that of control group(P<0.05),the first time of eating after operation and the first time of getting out of bed after operation in observation group were significantly earlier than those in control group(all P<0.05),the hospitalization expenses and postoperative complications were significantly lower than those in control group(all P<0.05).There was no significant difference in stone clearance rate between the two groups at 4 weeks after operation(P>0.05).The scores of role limitation,physiological function,social function and general health of the two groups at 4 weeks after operation were significantly higher than those of 1 day before operation(all P<0.05),the above scores of observation group were significantly higher than those of control group 4 weeks after operation(all P<0.05).Conclusion Perioperative application of FTS intervention for flexib

关 键 词：快速康复外科 输尿管中上段结石 肾积水 输尿管软镜 预后 

分 类 号：R699[医药卫生—泌尿科学]