侧卧体位输尿管软镜取石术治疗输尿管上段结石的临床应用价值  

The clinical value of soft ureteroscopic in lateral position in the treatment of upper ureteral calculi

作　　者：赵勇 张旭 施国洪 许志宏 ZHAO Yong;ZHANG Xu;SHI Guohong;XU Zhihong(Department of Urology,the First Affiliated Hospital of Fujian Medical University,Nanping,Fujian,353000,China)

机构地区：[1]福建省医科大学附属南平市第一医院泌尿外科,福建南平353000

出　　处：《当代医学》2023年第9期170-173,共4页Contemporary Medicine

摘　　要：目的探讨侧卧体位输尿管软镜取石术治疗输尿管上段结石的临床疗效。方法选取2017年3月至2020年4月本院收治的208例输尿管上段结石患者作为研究样本,按照随机数字表法分为对照组(n=101)与观察组(n=107)。对照组采用传统截石位进行输尿管软镜取石术,观察组在健侧卧位+截石位下开展输尿管软镜取石术,比较两组一次碎石成功患者手术时间、住院费用、住院时间、并发症发生情况、C反应蛋白(CRP)及白细胞计数(WBC)。结果最终纳入研究例数:观察组82例,对照组78例。两组住院总费用、术后住院时间、术后并发症发生率、无法置入输尿管软镜导引鞘发生率、一次碎石成功率比较差异无统计学意义;观察组手术时间[(52.58±16.05)min]短于对照组[(61.94±14.38)min],观察组结石排尽率为89.02%,高于对照组的75.64%,差异有统计学意义(P<0.05);术后1 d,两组CRP水平、WBC均高于术前,但观察组WBC低于对照组,差异有统计学意义(P<0.05),两组CRP水平比较差异无统计学意义。结论在健侧卧体位+传统截石位下开展输尿管软镜取石术治疗输尿管上段结石,临床效果显著,能提高碎石成功率,缩短手术时间,值得临床推广应用。Objective To investigate the clinical effect of soft ureterolithotomy in lateral position in the treatment of upper ureteral calculi.Methods A total of 208 patients with upper ureteral calculi admitted to our hospital from March 2017 to April 2020 were selected as the study sub-jects,and they were divided into the control group(n=101)and the observation group(n=107)by random number table method.The control group underwent soft ureteral lithotomy at traditional lithotomy position,while the observation group underwent soft ureteral lithotomy at healthy lateral po-sition plus lithotomy position,the operation time,hospital cost,hospital stay,complications,C-reactive protein(CRP)and white blood cell count(WBC)were compared between the two groups.Results There were 82 cases in the observation group and 78 cases in the control group.There were no significant differences in total hospital cost,postoperative length of stay,incidence of postoperative complications,incidence of non-placement of ureteral flexible lens guided sheath,and success rate of single lithotripsy between the two groups.The operation time([52.58±16.05]min)in the observation group was shorter than([61.94±14.38]min)in the control group,and the stone expulsion rate in the observation group was 89.02%,which was higher than that in the control group(75.64%),the difference was statistically significant(P<0.05).One day after operation,the levels of CRP and WBC in two groups were higher than those before operation(P<0.05),but the WBC count in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05),there was no significant difference in CRP levels between the two groups.Conclusion Soft ureteral lithotomy with healthy lateral position and traditional lithotomy position is effective in the treatment of upper ure-teral calculi,which can improve the success rate of lithotripsy and reduce the operation time,and has significant advantages in clinical application.

关 键 词：侧卧体位 输尿管软镜取石术 输尿管上段结石 

分 类 号：R699.4[医药卫生—泌尿科学]