输尿管结石合并新冠感染患者手术时机的选择  

Choice of operation time for ureteral calculi patients with COVID-19 infection

作　　者：梁磊[1] 马龙劼 张彤[1] 郭二卫 李明 Liang Lei;Ma Longjie;Zhang Tong;Guo Erwei;Li Ming(Department of Urology,Beijing Puren Hospital,Beijing 100062,China)

机构地区：[1]北京市普仁医院泌尿外科,北京100062

出　　处：《国际外科学杂志》2024年第2期103-107,共5页International Journal of Surgery

摘　　要：目的比较输尿管结石合并新冠感染患者在新冠感染期间和痊愈后进行手术的差异性,以寻找最佳的手术时机。方法回顾性分析2022年12月—2023年1月北京市普仁医院收治的327例输尿管结石合并新冠感染患者的临床资料,其中先后实施输尿管镜手术治疗141例,根据实施输尿管镜手术治疗的时间分为新冠感染痊愈前手术组(n=81)和新冠感染痊愈后手术组(n=60),对比分析两组患者的一期手术成功率、结石清除率、并发症发生率、病死率、手术时间、术后血红蛋白下降值、住院时间、住院总费用等指标。计量资料以均数±标准差(±s)表示,组间比较采用独立样本t检验;计数资料组间比较采用χ^(2)检验或连续校正χ^(2)检验。结果新冠感染痊愈前手术组患者的一期手术成功率(38.3%,31/81)、结石清除率(86.4%,70/81)均明显低于新冠感染痊愈后手术组[80.0%(48/60),98.3%(59/60)],差异均具有统计学意义(P<0.05)。而并发症发生率以及术后血红蛋白下降值[(2.1±0.6)g/L比(0.6±0.3)g/L]、住院时间[(14.7±3.6)d比(4.1±1.1)d]、住院总费用[(34733.3±4412.4)元比(21919.7±3251.3)元]明显高于新冠感染痊愈后手术组,差异均具有统计学意义(P<0.001)。新冠感染痊愈前手术组患者的手术时间更短[(16.9±5.4)min比(37.7±8.9)min],差异具有统计学意义(P<0.001)。两组患者的病死率比较(3.7%比0),差异无统计学意义(P>0.05)。结论输尿管结石患者合并新冠感染时进行手术治疗风险很高,应尽可能保守治疗待其新冠感染痊愈后再行手术治疗。Objective To compare the difference between the operation of ureteral calculi patients with COVID-19 infection during COVID-19 infection and after recovery to find out the best timing for surgery.Methods The clinical data of 327 ureteral calculi patients with COVID-19 infection were retrospectively analyzed,including 141 cases who underwent ureteroscopic surgery.According to the time of ureteroscopic surgery,the patients were divided into two groups:operation before recovery of COVID-19 infection group(n=81)and operation after recovery of COVID-19 infection group(n=60).The success rate of primary surgery,stone removal incidence,complication inciednce,mortality,operation time,postoperative hemoglobin decline,hospital stay,and total hospitalization cost and other indicators of the two groups were compared between the two groups.Measurement data were expressed as mean±standard deviation(±s),independent t-test was used for inter-group comparison.Chi-test or continuous correction Chi-test was used for inter-group comparison for count data.Results The success rate of primary surgery(38.3%,31/81),stone removal rate(86.4%,70/81)in the operation before recovery of COVID-19 infection group were significantly lower than those in the operation after recovery of COVID-19 infection group[80.0%(48/60),98.3%(59/60)],and the differences were statistically significant(P<0.05).The incidence of complication,postoperative hemoglobin decline[(2.1±0.6)g/L vs(0.6±0.3)g/L],hospital stay[(14.7±3.6)d vs(4.1±1.1)d],total hospitalization cost[(34733.3±4412.4)yuan vs(21919.7±3251.3)yuan]of the operation before recovery of COVID-19 infection group were significantly higher than those in the operation after recovery of COVID-19 infection group,and the differences were statistically significant(P<0.001).The operation time of the operation before recovery of COVID-19 infection group was shorter[(16.9±5.4)min vs(37.7±8.9)min],and the difference was statistically significant(P<0.001).There was no significant difference in mortality betwee

关 键 词：输尿管结石 碎石术 激光 感染 新型冠状病毒肺炎 手术时间 

分 类 号：R699.4[医药卫生—泌尿科学] R563.1[医药卫生—外科学]