细输尿管镜钬激光碎石术治疗输尿管中下段结石多中心大样本应用体会  

Experience of fine ureteroscopic holmium laser lithotripsy for the treatment of middle and lower ureteral calculi

作　　者：陈少鹏 罗力 何祥 赵阳 叶钧 却学云 陶举堂 黄苏宁 宋玉堂 杨梓光 方紫薇 孟年文 李南南 胡合营 CHEN Shaopeng;LUO Li;HE Xiang;ZHAO Yang;YE Jun;QUE Xueyun;TAO Jutang;HUANG Suning;SONG Yutang;YANG Ziguang;FANG Ziwei;MENG Nianwen;LI Nannan;HU Heying(Zhengsheng Doctor GroupCo.,Ltd.,Shenzhen,Guangdong,518000,China;Department of Urology,Banger Hospital,Yuyao City,Zhejiang Province;Department of Urology,Guangzhou Jiahe Yimin Hospital;Department of Urology,Dafeng Youyi Hospital,Yancheng City,Jiangsu Province;Department of Urology,Banger Hospital,Xianju County,Zhejiang Province;Department of Urology,Guangzhou Xinshi Hospital;Department of Urology,Yaozhuang Hospital,Jiashan County,Zhejiang Province;Department of Urology,Honghui Hospital,Xingning City,Guangdong Province;Department of Urology,Youyi Hospital,Yueqing City,Zhejiang Province;Department of Urology,Shenzhen Overseas Chinese Hospital,Guangdong Province;Department of Urology,Kangda Hospital,Binhai County,Jiangsu Province;Department of Urology,Tongfang Lubao Hospital,Sanshui District,Foshan City,Guangdong Province)

机构地区：[1]正生医生集团(深圳)有限公司,广东深圳518000 [2]浙江省余姚市邦尔医院泌尿外科 [3]广州市嘉禾益民医院泌尿外科 [4]江苏省盐城市大丰友义医院泌尿外科 [5]浙江省仙居县邦尔医院泌尿外科 [6]广州市新市医院泌尿外科 [7]浙江省嘉善县姚庄医院泌尿外科 [8]广东省兴宁市鸿惠医院泌尿外科 [9]浙江省乐清市友义医院泌尿外科 [10]广东省深圳市华侨医院泌尿外科 [11]江苏省滨海县康达医院泌尿外科 [12]广东省佛山市三水区同方芦苞医院泌尿外科

出　　处：《临床泌尿外科杂志》2023年第12期966-969,共4页Journal of Clinical Urology

摘　　要：目的:评价细输尿管镜治疗输尿管中下段结石的应用效果。方法:本研究采用前瞻性、多中心进行,选取2021年10月—2022年9月正生医生集团多个临床中心收治的1298例输尿管中下段结石患者资料,分为细输尿管镜组(试验组)和标准输尿管镜组(对照组),其中试验组708例行细输尿管镜联合钬激光碎石治疗,对照组590例行标准输尿管镜钬激光碎石治疗,就2组的临床资料进行对比。结果:2组患者一般资料比较差异均无统计学意义(P>0.05);但术中上镜成功率、上镜难易程度、黏膜损伤程度、手术时间等方面,试验组应用效果均明显优于对照组(P<0.05),2组碎石取石效果和并发症比较差异无统计学意义(P>0.05)。结论:应用细输尿管镜钬激光治疗输尿管中下段结石碎石成功率高,损伤小且轻,尤其适用于输尿管结石较小的情况,术后疼痛轻,恢复快,且同时有更高的安全性,应用价值十分突出,细输尿管镜可作为输尿管中下段结石治疗优先选择的器械。Objective To evaluate the efficacy of fine ureteroscopy in the treatment of middle and lower ureteral calculi.Methods This study was a prospective and multicenter study.From October 2021 to September 2022,1298 patients with middle and lower ureteral calculi admitted to multiple clinical centers of Zhengsheng Doctor Group were selected and divided into the fine ureteroscope group(experimental group)and the standard ureteroscope group(control group).Seven hundred and eight cases underwent fine ureteroscopy combined with holmium laser lithotripsy and 590 cases underwent standard ureteroscopy with holmium laser lithotripsy.The clinical data of the two groups were compared.Results There was no significant difference in general data between the two groups(P>0.05).However,the success rate of ureteroscopy insertion,the difficulty degree of ureteroscopy insertion,the degree of mucosal injury,and the operation time of the fine ureteroscope group were significantly better than those of the standard ureteroscope group(P<0.05).There was no significant difference in the effect of lithotripsy or complications between the two groups(P>0.05).Conclusion The application of fine ureteroscopy holmium laser in the treatment of middle and lower ureteral calculi has a high success rate of lithotripsy,small and light damage,and is especially suitable for the case of small ureteral calculi.The application value is very prominent for its less postoperative pain,quick recovery,and higher safety,so it can be used as the preferred instrument for the treatment of middle and lower ureteral calculi.

关 键 词：输尿管结石 输尿管镜 多中心研究 

分 类 号：R693[医药卫生—泌尿科学]