输尿管软镜碎石术Ⅰ期治疗上尿路结石的疗效分析  

作　　者：廖开森[1] 蔡琦[1] 曹俊杰 陈静[1] 任黎刚[1] 

机构地区：[1]浙江省立同德医院,310012

出　　处：《浙江临床医学》2021年第11期1645-1647,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨输尿管软镜碎石术(f-URL)Ⅰ期治疗上尿路结石的疗效:方法收集2017年1月至2018年12月行输尿管软镜碎石术的患者,分为Ⅰ期碎石组237例,Ⅱ期碎石组(Ⅰ期预先放置输尿管双J管2周)165例,比较Ⅰ期碎石组与Ⅱ期碎石组在手术时间、碎石成功率、净石率、并发症发生率、总住院时间、总住院费用等方面的差异:结果Ⅰ期碎石组在总住院时间、总住院费用方面优于n期碎石组;碎石成功率n期碎石组优于Ⅰ期碎石组;手术时间、净石率、并发症发生率两组差异无统计学意义;Ⅰ期碎石组中老年患者、有生育史女性、有排石史及输尿管镜手术史的患者Ⅰ期碎石成功率较高,而<30岁年轻患者,特别是肥胖患者Ⅰ期碎石率成功率较低结论输尿管软镜碎石术Ⅰ期治疗上尿路结石安全可行,通过术前预判,有选择的对患者进行Ⅰ期碎石,既减少患者留置双J管的时间及留置双J管的痛苦,又缩短住院时间,降低医疗费用,提高患者的满意度。Objective To investigate the efficacy of flexible ureteroscopy lithotripsy(f-URL)in the treatment of upper urinary tract stones.Methods The patients who underwent flexible ureteroscope lithotripsy in our hospital from January 2017 to December 2018 were collected and divided into 237 cases in the first-stage lithotripsy group and the second-stage lithotripsy group(the first-stage double J tube was placed in advance for 2 weeks)165 cases,comparing the operation time,lithotripsy success rate,lithotripsy rate,complication rate,total hospital stay,total hospital cost,pain score,patients in the first-stage lithotripsy group and the second-stage lithotripsy group differences in satisfaction,etc.Results The first-stage lithotripsy group was better than the second-stage lithotripsy group in terms of tot«il hospital stay,total hospital cost,pain score,and patient satisfaction;the second-stage lithotripsy group was better than the first-stage lithotripsy group in terms of total hospital stay.There was no significant difference in stone removal rate,and complication rate.At the same time,middle-aged and elderly patients,women with fertility history,patients with history of stone removal and ureteroscopy were found in the first-stage lithotripsy group had a higher success rate,while the success rate of the first-stage lithotripsy is lower in young patients under 30,especially obese patients.Conclusion Flexible ureteroscope lithotripsy is safe and feasible for the first-stage treatment of upper urinary tract stones.Doctors pre-judgment before surgery and selectively perfomi one-stage lithotripsy on patients,which can reduce the time and pain of indwelling of double J tube,shortens the hospital stay,reduces medical expenses,and improves patient satisfaction.

关 键 词：输尿管软镜碎石术 上尿路结石 Ⅰ期 疗效分析 

分 类 号：R69[医药卫生—泌尿科学]