软-硬镜联合治疗复杂性输尿管上段结石患者的临床效果  

Clinical Effect of Combined Soft and Hard Ureteroscopy in the Treatment of Patients with Complex Upper Ureteral Calculi

作　　者：潘伟 PAN Wei(Department of Urology,Luoshan County People’s Hospital,Xinyang 464200,China)

机构地区：[1]罗山县人民医院泌尿外科,河南信阳464200

出　　处：《河南医学研究》2021年第21期3929-3932,共4页Henan Medical Research

摘　　要：目的研究软-硬镜联合治疗复杂性输尿管上段结石(UUC)患者的临床效果。方法选取2018年10月至2020年12月罗山县人民医院收治的166例复杂性UUC患者作为研究对象,根据治疗方法分为软-硬镜联合组(107例)和微创经皮肾镜组(59例)。微创经皮肾镜组接受微创经皮肾镜治疗,软-硬镜联合组接受输尿管软-硬镜联合治疗,应用倾向性评分配比法(1∶1,卡钳值=0.01),基于性别、年龄、结石部位、结石数量及结石直径,将软-硬镜联合组和微创经皮肾镜组配对。比较倾向性评分配比后两组术中指标、术前及术后炎症因子水平[C反应蛋白(CRP)、白细胞介素(IL)-6],统计患者结石清除率及术后并发症发生情况。结果倾向性评分配比前,两组性别、年龄、结石部位、结石数量比较,差异无统计学意义(P>0.05);软-硬镜联合组结石直径大于微创经皮肾镜组,差异有统计学意义(P<0.05);倾向性评分配比后,两组性别、年龄、结石部位、结石直径、结石数量比较,差异无统计学意义(P>0.05)。软-硬镜联合组术中出血量少于微创经皮肾镜组,手术时间短于微创经皮肾镜组,差异有统计学意义(P<0.05)。术前,两组血清CRP、IL-6水平比较,差异无统计学意义(P>0.05);术后1 d,两组血清CRP、IL-6水平升高,但软-硬镜联合组低于微创经皮肾镜组,差异有统计学意义(P<0.05)。术后1个月,软-硬镜联合组结石清除率(94.23%)高于微创经皮肾镜组(71.15%),差异有统计学意义(P<0.05);两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论与微创经皮肾镜比较,软-硬镜联合治疗可缩短复杂性UUC患者手术时间,减少术中出血量,减轻患者炎症反应,提高结石清除率,未增加术后并发症发生率。Objective To study the clinical effect of combined soft and hard ureteroscopy in the treatment of patients with complex upper ureteral calculi(UUC).Methods The clinical data of 166 patients with complex UUC treated in Luoshan County People’s Hospital from October 2018 to December 2020 were retrospectively analyzed,and the patients were divided into the combined soft and hard ureteroscopy group(107 cases)and the minimally invasive percutaneous nephrolithotomy group(59 cases)according to the treatment methods.The minimally invasive percutaneous nephrolithotomy group were treated by minimally invasive percutaneous nephrolithotomy,and the combined soft and hard ureteroscopy group were treated by combined soft and hard ureteroscopy.The propensity score matching method(1∶1,caliper value=0.01)was used,based on gender,age,calculi location,calculi number and calculi diameter,the combined soft and hard ureteroscopy group and the minimally invasive percutaneous nephrolithotomy group were matched.The intraoperative indexes,preoperative and postoperative levels of inflammatory factors[C-reactive protein(CRP),interleukin(IL)-6]were compared between the two groups.The calculi clearance rate and the occurrence of postoperative complications of patients were analyzed.Results Before matching the propensity score,there was no statistically significant difference in gonder,age,stone location and number of stones between the two groups(P>0.05);the diameter of stones in the combined soft and hard ureteroscopy group was larger than that in the minimally invasive percutaneous nephrolithotomy group(P<0.05).After matching the propensity score,there was no difference in baseline data between the two groups(P>0.05).The intraoperative blood loss in the combined soft and hard ureteroscopy group was less than that in the minimally invasive percutaneous nephrolithotomy group,and the operation time was shorter than that in the minimally invasive percutaneous nephrolithotomy group(P<0.05).Before operation,there was no significant difference i

关 键 词：复杂性输尿管上段结石 软-硬镜联合 微创经皮肾镜 

分 类 号：R693[医药卫生—泌尿科学]