经皮肾镜联合输尿管软镜治疗复杂输尿管结石  

Percutaneous nephroscope combined with retrograde ureteroscopic holmium laser lithotripsy for the treatment of complex ureteral calculi

作　　者：杨宇 詹绍洋 盖龙 徐庆平 项国栋 Yang Yu;Zhan Shaoyang;Gai Long;Xu Qingping;Xiang Guodong(Department of Urology,Hefei BOE Hospital,Anhui,Hefei 230041)

机构地区：[1]合肥京东方医院泌尿外科,安徽合肥230041

出　　处：《现代科学仪器》2021年第5期123-127,共5页Modern Scientific Instruments

摘　　要：目的:探讨经皮肾镜联合输尿管软镜治疗复杂输尿管结石的效果。方法:回顾性分析2019年3月~2020年12月合肥京东方医院收治的186例复杂输尿管结石患者的临床资料,其中,80例患者标记为A组,采用经皮肾镜联用气压弹道碎石术进行治疗,其余的106例患者记为B组,采用的则是经皮肾镜联合输尿管软镜激光治疗。对比2组患者的手术时间、术中出血量、住院时间;对比2组患者不同时刻点的氧化应激指标的变化情况;比较2组患者治疗后7 d结石清除率及治疗后7 d并发症发生率。结果:B组的术中出血量少于A组,住院时间短于A组,手术时间长于A组,差异均具有统计学意义(P<0.05);皮质醇(Cor)、丙二醛(MDA)、超氧化物歧化酶(SOD)时间、组间、交互作用对比差异均有显著性(P<0.05);与治疗前比,治疗后1d和7d两组Cor、MDA均显著升高(P<0.05),SOD显著降低(P<0.05);与治疗后1d比,治疗后7 d两组Cor、MDA均显著升高(P<0.05),SOD显著降低(P<0.05);治疗后B组Cor、MDA均低于A组(P<0.05),SOD均高于A组(P<0.05);B组治疗后7 d的结石清除率均显著高于A组(P<0.05),2组治疗后7 d并发症发生率相比,差异不具有统计学意义(P>0.05)。结论:经皮肾镜联合输尿管软镜治疗复杂输尿管结石具有术中出血量少、住院时间短、氧化应激反应轻、结石清除率高的优点,且不会增加并发症发生率,不足之处在于手术时间延长。Objective:Percutaneous nephroscope combined with flexible ureteroscopy in the treatment of complex ureteral calculi.Methods:The clinical data of 186 patients with complex ureteral calculi admitted to Hefei BOE Hospital from March 2019 to December 2020 were retrospectively analyzed.Among them,80 patients were marked as group A and treated with percutaneous nephroscope combined with pneumatic lithotripsy,and the remaining 106 patients were recorded as group B with percutaneous nephroscope combined with retrograde flexible ureteroscopy and holmium laser Lithotripsy treatment.Operation time,Intraoperative blood loss,and hospitalization time were compared between the two groups.The changes of oxidative stress indexes at different time points in the two groups were compared.The stone clearance rates and the incidence of postoperative complications 7 days after treatment were compared between the two groups.Results:The intraoperative blood loss in group B was less than that in group A,the hospital stay was shorter than that in group A,and the operation time was longer than that in group A,with statistically significant differences(P<0.05).There were significant differences in Cortisol(Cor),Malondialdehyde(MDA)and Superoxide dismutase(SOD)time,intergroup and interaction(P<0.05).Compared with before treatment,Cor and MDA were significantly increased on day 1 and 7 after treatment(P<0.05),and SOD was significantly decreased(P<0.05).Compared with day 1 after treatment,Cor and MDA were significantly increased(P<0.05)and SOD was significantly decreased(P<0.05)in both groups at day 7 after treatment.After treatment,Cor and MDA levels in group B were lower than those in group A(P<0.05),and SOD levels were higher than those in group A(P<0.05).The stone clearance rate of group B was significantly higher than that of group A at 7 d after treatment(P<0.05).The incidence of postoperative complications between the two groups was not statistically significant(P>0.05).Conclusion:Percutaneous nephroscopy combined with retrograde flexibl

关 键 词：经皮肾镜术 输尿管软镜钬激光碎石术 输尿管结石 

分 类 号：R69[医药卫生—泌尿科学]