一次性输尿管软镜和重复性输尿管软镜治疗肾下盏结石的疗效分析  

Analysis of efficacy between disposable and reusable flexible ureteroscopy in the treatment of renal lower pole calculi

作　　者：张志昱 宋振 周奇 欧阳骏[1] 张江磊[1] Zhang Zhiyu;Song Zhen;Zhou Qi;Ouyang Jun;Zhang Jianglei(Department of Urology,the First Afiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院泌尿外科,苏州215000

出　　处：《国际泌尿系统杂志》2023年第2期193-196,共4页International Journal of Urology and Nephrology

基　　金：江苏省自然科学基金(青年基金项目)(BK20190175);苏州市科技计划项目(SYS2019053)。

摘　　要：目的探讨重复性输尿管软镜(FURS)和一次性FURS治疗肾下盏结石的疗效.方法回顾性分析2020年1月至2021年3月在本院治疗的206例肾下盏结石患者的临床资料,根据手术方式分为重复性FURS组(154例)及一次性FURS组(52例).比较两组的一般情况、结石侧别、结石长径、结石数量、结石密度、肾盂肾下盏漏斗夹角(IPA)等方面的差异.结果两组的一般情况、结石侧别、结石长径、结石数量、结石密度、IPA、术后并发症、住院时间及结石清除率比较,差异均无统计学意义(均P>0.05).重复性FURS组的手术时间高于一次性FURS组[(42.96±16.81)min vs.(37.31±14.88)min,P=0.041],而住院费用低于一次性FURS组[(23492.60±5151.34)元vs.(29262.33±2099.96)元,P<0.001].结石数量、结石长径、结实密度及术后并发症与手术时间均有相关性(均P<0.05).通过logistic回归分析结果得出,结石数量、结石长径及手术方式均为影响手术时间的独立危险因素(均P<0.05).结论对于肾下盏结石的治疗,一次性FURS与重复性FURS的疗效相似.对于肾下盏结石数量较多、结石长径较大的患者,在经济情况的允许下,可优先选择一次性FURS,可缩短手术时间.Objective To compare the efficacy of reusable flexible ureteroscopy(FURS)and disposable FURS in the treatment of renal lower pole calculi.Methods The clinical data of 206 patients with lower calyx calculi treated in our hospital from January 2020 to March 2021 were retrospectively analyzed.The patients were divided into reusable FURS group(154 cases)and disposable FURS group(52 cases)according to different surgical methods.Differences of demographic characteristics,lithotripsy on the side,long diameter,number of calculi,stone hounsfield unit(HU),infundibulopelvic angle(IPA),operation time,complication rate,hospitalization time,stone free rate(SFR)and hospitalization expenses between disposable FURS group and reusable FURS group were compared.Results There were no significant differences in general condition,lithotripsy on the side,long diameter,number of calculi,HU,IPA,postoperative complications,hospital stay and stone clearance rate between the two groups(all P>0.05).The operation time of the reusable FURS group was higher than that of disposable FURS group[(42.96±16.81)min vs.(37.31±14.88)min,P=0.041].The hospitalization cost of reusable FURS group was lower than that of disposable FURS group[(23492.60±5151.34)yuan vs.(29262.33±2099.96)yuan,P<0.001].The number of calculi,the long diameter,HU and postoperative complications were correlated with the operation time(all P<0.05).Logistic regression analysis showed that the number of calculi,the long diameter and surgical methods were independent risk factors affecting the operation time(all P<0.05).Conclusions For the treatment of renal lower pole calculi,the efficacy of disposable FURS is similar to that of reusable FURS.For patients with multiple stones and lager diameter,the disposable FURS may be preferred if economic conditions permit because it will bring a shorter operation time.

关 键 词：肾结石 输尿管镜检查 一次性 重复性 

分 类 号：R692.4[医药卫生—泌尿科学]