输尿管镜联合剥皮鞘经尿道钬激光碎石术在下尿路结石手术中的临床应用  

Clinical application of ureteroscopy combined with peeling sheath transurethral holmium laser lithotripsy in the surgery of lower urinary tract stones

作　　者：张汝 苏林智 ZHANG Ru;SU Linzhi(Department of Urology,Yichun Second People's Hospital,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市第二人民医院泌尿外科,江西宜春336000

出　　处：《当代医学》2023年第17期34-37,共4页Contemporary Medicine

基　　金：江西省卫生计生委科技计划项目(202212622)。

摘　　要：目的探究输尿管镜联合剥皮鞘在下尿路结石手术中的临床应用效果。方法选取2017年1月至2021年9月本院收治的60例下尿路结石患者作为研究对象,按照随机数字表法分为A组、B组与C组,每组20例。A组采用传统耻骨上膀胱切开取石术治疗,B组采用经尿道膀胱镜钬激光碎石术治疗,C组采用输尿管镜联合剥皮鞘经尿道钬激光碎石术治疗,比较3组手术时间、留置导尿管时间、住院时间、术后疼痛程度[视觉模拟评分法(VAS)]、术后血尿发生率、术后残留结石碎片率及手术治疗满意度。结果C组手术时间、留置导尿管时间、住院时间均明显短于A组与B组,且B组短于A组,差异有统计学意义(P<0.05)。C组术后VAS评分明显低于A组与B组,且B组低于A组,差异有统计学意义(P<0.05)。C组术后血尿发生率、术后残留结石碎片率均明显低于B组与A组,且B组低于A组,差异有统计学意义(P<0.05)。C组治疗总满意度明显高于A组,差异有统计学意义(P<0.05);C组与B组、B组与A组总满意率比较差异无统计学意义。结论输尿管镜联合剥皮鞘经尿道钬激光碎石术治疗下尿路结石效果确切,能有效取净结石,缩短手术时间、留置导尿管时间及住院时间,减轻术中损伤,降低术后血尿发生率,提升患者满意程度,具有较高的临床价值。Objective To explore the clinical effect of ureteroscopy combined with peeling sheath transurethral holmium laser lithotripsy in the surgery of lower urinary tract stones.Methods Atotal of 60 patients with lower urinary tract stones admitted to our hospital from January 2017 to September 2021 were selected as the research subjects,and they were divided into the group A,group B and group C according to the random number table method,with 20 cases in each group.GroupAwas treated with traditional suprapubic cystolithotomy,group B was treated with transurethral cystoscopic holmium laser lithotripsy,and group C was treated with ureteroscopy combined with peeling sheath transurethral holmium laser lithotripsy,the operation time,indwelling catheter time,hospitalization time,postoperative pain degree(visual analogue scale[VAS]),postoperative hematuria incidence,postoperative residual stone fragment rate and surgical treatment satisfaction were compared among the three groups.Results The operation time,indwelling catheter time and hospitalization time in the group C were significantly shorter than those in the group A and group B,and the group B was shorter than the group A,the differences were statistically significant(P<0.05).The postoperative VAS score in the group C was significantly lower than that in the groupAand group B,and the group B was lower than the group A,the difference was statistically significant(P<0.05).The incidence of postoperative hematuria and postoperative residual stone fragments in the group C were significantly lower than those in the group B and group A,and the group B was lower than the group A,the differences were statistically significant(P<0.05).The total satisfaction of group C was significantly higher than that of group A,the difference was statistically significant(P<0.05).There was no significant difference in the total satisfaction rate between group C and group B and between group B and group A.Conclusion Ureteroscopy combined with peeling sheath transurethral holmium laser lithotrips

关 键 词：输尿管镜 剥皮鞘 下尿路结石 临床应用 

分 类 号：R699[医药卫生—泌尿科学]