低压灌注技术在输尿管镜钬激光碎石术中的临床价值分析  

Clinical value of low-pressure irrigation technique in ureteroscopic lithotripsy

作　　者：唐宵峰 邹智聪 林元田 徐杰 吴银锁 林国太 Tang Xiaofeng;Zou Zhicong;Lin Yuantian;Xu Jie;Wu Yimuo;Lin Guotai(Department of Urology,the First Hospital of Putian City,Putian 351100,China)

机构地区：[1]福建医科大学教学医院莆田市第一医院泌尿外科,莆田351100

出　　处：《国际泌尿系统杂志》2021年第1期16-19,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨输尿管导管外引流及手持针筒注水等低压灌注技术在输尿管镜钬激光碎石术中的临床应用价值,分析其可行性、实用性及临床疗效。方法选取2019年2月至2020年1月在本院行输尿管镜下钬激光碎石术的12例输尿管结石患者为研究对象,根据术中灌注方式将其分为低压灌注组和普通灌注组。低压灌注组在输尿管导管外引流及手持针筒注水等低压灌注下行输尿管镜钬激光碎石术;普通灌注组在灌注泵灌注下行输尿管镜钬激光碎石术。分别比较两组的手术时间、疗效和术后并发症的发生率。结果两组手术时间比较,差异无明显统计学意义(P>0.05),低压灌注组的结石残留率明显低于普通灌注组(P<0.05),其术后肾区疼痛、肉眼血尿及全身炎症反应综合征等并发症的发生率均明显低于普通灌注组(P<0.05)。结论输尿管导管外引流及手持针筒注水等低压灌注技术,在输尿管镜钬激光碎石术中可操作性强,可降低残石率,并减少术后感染等并发症的发生,具有一定的临床应用价值。Objective To investigate the clinical value of low-pressure irrigation technique such as external drainage of ureteral catheter and irrigation with hand-held syringe in ureteroscopic holmium laser lithotripsy,and to analyze its feasibility,practicability and clinical effect.Methods From February 2019 to January 2020,120 patients who underwent ureteroscopic holmium laser lithotripsy were randomly divided into two groups:low-pressure perfusion group and general perfusion group.In the low-pressure perfusion group,F4 ureteral catheter was placed below the stone through ureteroscope to form a return channel.The assistant used a 50 mL syringe and a three-way infusion tube to slowly inject water from the side hole of ureteroscope.In the general perfusion group,ureteroscopic holmium laser lithotripsy was performed with perfusion pump.The time and effect of operation and the incidence of postoperative complications were compared between the two groups.Results There was no significant difference in operation time between the two groups(P>0.05).The technique of lowpressure perfusion could significantly reduce the incidence of stone residue(P<0.05),and with lower incidence of early complications such as postoperative pain in renal area,gross hematuria,transient renal dysfunction and systemic inflammatory response syndrome than that of the general perfusion group(P<0.05).Conclusions The technique of low-pressure irrigation,such as external drainage of ureteral catheter and irrigation with hand-held syringe,is highly operable in ureteroscopic holmium laser lithotripsy,reduces the incidence of stone residue and complications such as systemic inflammatory response syndrome,has clinical application value.

关 键 词：输尿管结石 输尿管镜检查 碎石术 激光 低压灌注 

分 类 号：R699.4[医药卫生—泌尿科学]