输尿管镜碎石加支架管置入对术后上尿路结石自行排出的影响  

Effect of uretercscopy combined with stent placement on postoperative auto-release of upper urinary calculi

作　　者：孙柳静[1] 朱喜山[1] SUN Liujing;ZHU Xishan(Department of Urology,Third People’s Hospital of Changzhou,Changzhou 213000,CHINA)

机构地区：[1]常州市第三人民医院泌尿外科,江苏213000

出　　处：《江苏医药》2021年第5期512-515,共4页Jiangsu Medical Journal

摘　　要：目的观察输尿管镜碎石(URS)加支架管置入对术后上尿路结石自行排出的作用。方法 390例上尿路结石患者中,178例患者行URS加支架管置入(URS组),212例患者行体外冲击波碎石(ESWL组)。记录两组治疗前后输尿管跨过髂血管处狭窄管径、治疗后1个月无石率和随访期间结石自行排出情况。结果 URS组治疗后输尿管跨过髂血管处狭窄管径较治疗前增加[(6.06±1.26) mm vs.(3.63±0.98) mm](P<0.01);而ESWL组治疗后输尿管跨过髂血管处狭窄管径与治疗前比较差异无统计学意义[(3.65±0.99) mm vs.(3.67±0.99) mm](P>0.05)。URS组治疗后1个月无石率高于ESWL组(88.2%vs. 75.9%)(P<0.01),且随访期间结石自行排出率亦高于ESWL组(9.0%vs.2.8%)(P<0.01)。结论 URS加支架管置入较ESWL可以更为有效地自行排出上尿路结石。支架管置入后输尿管扩张是促进结石排出的主要原因。Objective To observe the effect of uretercscopy combined with stent placement on the postoperative auto-release of upper urinary calculi.Methods Of 390 patients with upper urinary calculi, 178 cases accepted uretercscopy plus stent placement(group A) and 212 cases received extracorporeal shock wave lithotripsy(group B).The short diameter of the ureter surpassing the stenosis of iliac vessels before and after operation, stone free rate in the 1st month after operation and auto-release of urinary calculi during the follow-up period were recorded in both groups.ResultsCompared with before, the short diameter of the ureter surpassing the stenosis of iliac vessels after operation was increased in group A [(6.06±1.26) mm vs.(3.63±0.98) mm](P<0.01).While there was no statistical difference in the short diameter of the ureter surpassing the stenosis of iliac vessels before and after operation in group B [(3.65±0.99) mm vs.(3.67±0.99) mm](P>0.05).The stone free rate in the 1st month after operation and auto-release of urinary calculi during the follow-up period in group A were higher than those in group B(88.2% vs.75.9% and 9.0% vs.2.8%)(P<0.01).Conclusion Compared with extracorporeal shock wave lithotripsy, uretercscopy combined with stent placement could more effectively promote the auto-release of upper urinary calculi.The dilation of the ureter after stent placement is the main reason for enhancing stone discharge.

关 键 词：尿路结石 输尿管镜 输尿管支架管 体外冲击波碎石术 

分 类 号：R691[医药卫生—泌尿科学]