输尿管软镜结合输尿管硬镜治疗复杂上尿路结石的效果评价及对预后的影响  

Effect evaluation and prognosis influence of the soft ureteroscope combined with hard ureteroscope on treatment of complex upper urinary tract calculi

作　　者：苏继峰 李文泽 蒋庆详 谭振坤 张磊 黎礼元 SU Ji-feng;LI Wen-ze;JIANG Qing-xiang;TAN Zhen-kun;ZHANG Lei;LI Li-yuan(Department of Urology,Xiangtan First People's Hospital of Hunan Province,Xiangtan City,Hunan Province,411000,China)

机构地区：[1]湖南省湘潭第一人民医院泌尿外科,湖南湘潭411000

出　　处：《蛇志》2021年第1期38-40,62,共4页Journal of Snake

摘　　要：目的探讨输尿管软镜协同输尿管硬镜治疗复杂上尿路结石的临床效果。方法选择我院收治的复杂上尿路结石患者96例,按入院顺序分为对照组和观察组,每组48例。对照组采取输尿管硬镜钬激光碎石术治疗,观察组采取输尿管软镜协同输尿管硬镜钬激光碎石术治疗。比较两组患者1次性碎石成功率、结石彻底清除率、炎症反应情况以及生活质量、住院时间、术后并发症发生率、疾病复发率。结果观察组患者的1次性碎石成功率、结石彻底清除率均高于对照组,两组比较差异有统计学意义(均P<0.05)。术后3 d,观察组的肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C-反应蛋白(CRP)水平均较对照组降低,差异有统计学意义(均P<0.05)。术后1周,两组患者的生活质量比较,观察组的生活质量量表(SF-36)评分明显高于对照组,住院时间短于对照组,两组比较差异有统计学意义(均P<0.05)。两组患者的并发症发生率、疾病复发率比较,观察组均明显低于对照组,差异有统计学意义(均P<0.05)。结论输尿管软镜联合输尿管硬镜治疗复杂上尿路结石的效果满意,且创伤小,结石清除率高,不良反应低,具有一定临床应用价值。Objective To investigate the clinical effect of soft ureteroscope combined with hard ureteroscope in the treatment of complex upper urinary tract calculi.Methods 96 patients with complex upper urinary tract calculi in our hospital were divided into control group and observation group according to admission order,48 cases in each group.The control group was treated with ureteroscopic holmium laser lithotripsy,and the observation group was treated with soft ureteroscope combined with ureteroscopic holmium laser lithotripsy.The success rate of primary lithotripsy,complete stone clearance rate,inflammatory response,quality of life,length of hospital stay,incidence of postoperative complications and disease recurrence rate were compared between the two groups.Results The observation group of patients with once success rate of gravel,stones thoroughly clearance rate were higher than control group,two groups compare the difference was statistically significant(P<0.05).Postoperative 3 d,tumor necrosis factor(TNF)alpha,interleukin 6(IL-6)and C reactive protein(CRP)levels of the observation group were lower than control group(P<0.05).Postoperative 1 week,the observation group's quality of life scale(SF,36)score significantly higher than the group,the hospital was shorter than the control group,two groups compare the difference was statistically significant(P<0.05).Two groups of patients with complications,disease recurrence rate comparison,the observation group were significantly lower than the control group(P<0.05).Conclusion Soft ureteroscope combined with hard ureteroscope in the treatment of complex upper urinary tract calculi is satisfactory,with small trauma,high stone clearance rate and low adverse reactions,and has certain clinical application value.

关 键 词：复杂上尿路结石 输尿管硬镜 输尿管软镜 钬激光碎石术 治疗效果 

分 类 号：R692.4[医药卫生—泌尿科学]