未预置双J管一期输尿管软镜治疗上尿路结石的安全性及疗效分析  

作　　者：徐胜利 曹春丽 周胜华 张启辉 徐哲丰[2] 

机构地区：[1]浙江中医药大学,310053 [2]中国人民武装警察部队海警总队医院,314000

出　　处：《浙江临床医学》2021年第10期1454-1456,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨术前未留置双J管的上尿路结石患者一期采用输尿管软镜处理结石的安全性及疗效。方法262例需行输尿管软镜手术的上尿路结石患者随机分为观察组和对照组,每组各131例。观察组术前不预置双J管,采用一期直接输尿管软镜手术;对照组采用预置双J管2周左右,再行二期输尿管软镜手术。比较两组的手术时间、输尿管软镜鞘置入的成功率、围手术期并发症的发生率以及结石的清除率。结果观察组的手术时间平均(71.36±12.15)min,对照组的手术时间平均(69.52±11.06)min,两组比较差异无统计学意义(P=0.201)。观察组的置鞘成功率为93.89%,对照组的置鞘成功率为98.47%,两组差异无统计学意义(P=O.053)。观察组的清石率为95.42%,对照组的清石率为94.66%,差异无统计学意义(P=1.000)。两组的并发症发生情况比较,差异无统计学意义(P>0.05)。结论术前未置双J管一期输尿管软镜处理上尿路结石的疗效满意,且具有微创、安全、费用低、痛苦少等优点。Objective To treat the upper urinary tract calculi without double J tube before operation with ureteroscope,the curative effect and safety were analyzed.Methods 262 patients with upper urinary calculi requiring flexible ureteroscopy were randomly divided into observation group and control group,131 cases in each group.The observation group was treated with one-stage direct ureteroscopy without double J tube before operation.The control group was treated with two-stage flexible ureteroscopy after two weeks.The operation time,the success rate of flexible ureteroscope sheath implantation,the incidence of perioperative complications,and the stone clearance rate after reexamination were statistically analyzed.Results The average operation time of the observation group was(71.36±12.15)minutes,while that of the control group was(69.52±11.06)minutes.There was no significant difference betAveen the two groups(P=0.201).The success rate of sheathing was 93.89% in the observation group and 98.47% in the control group,and there was no statistical significance between the two groups(P=0.053).The stone removal rate of the observation group was 95.42%,and that of the control group was 94.66%,with no statistical significance(P=1.000).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The treatment of tipper urinary tract calculi with one-stage flexible ureteroscope without double J tube before operation has the same characteristics of minimally invasive,safe and satisfactory effect,as well as the advantages of reducing cost and pain.

关 键 词：一期 输尿管软镜 上尿路结石 安全性 疗效 

分 类 号：R69[医药卫生—泌尿科学]