输尿管软镜与可弯曲负压吸引鞘治疗结石梗阻合并感染的效果  

Effectiveness of Flexible Ureteroscopy and Deflectable Negative Pressure Suction Sheath in Treating Stone Obstruction Complicated with Infection

作　　者：杨和明 夏建军 应美红 YANG Heming;XIA Jianjun;YING Meihong(Department of Urology,People's Hospital of Ruijin City,Ruijin 342500,China;不详)

机构地区：[1]瑞金市人民医院泌尿外科,江西瑞金342500 [2]瑞金市人民医院麻醉科,江西瑞金342500

出　　处：《中国医学创新》2024年第18期58-62,共5页Medical Innovation of China

摘　　要：目的:探讨肾盂输尿管软镜下前端可弯曲负压吸引鞘治疗结石梗阻合并感染的有效性和安全性。方法:选择2022年1月—2023年12月瑞金市人民医院收治的100例输尿管结石梗阻合并感染患者纳入研究,通过电脑随机编码的方法,分为对照组(n=50)和试验组(n=50)。对照组采用肾盂输尿管软镜结合普通软镜外鞘的治疗方案,试验组采用肾盂输尿管软镜联合前端可弯曲负压吸引鞘的治疗方案。比较两组患者临床疗效、一次性结石清除率、手术指标、术前1 d和术后2周的血清指标[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)]及治疗2周内的并发症发生情况。结果:试验组临床总有效率和一次性结石清除率均高于对照组,差异均有统计学意义(P<0.05)。试验组手术时间和住院时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。术后2周两组患者的PCT、TNF-α和CRP水平均降低,且试验组均低于对照组,差异均有统计学意义(P<0.05)。术后2周内,试验组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:肾盂输尿管软镜联合前端可弯曲负压吸引鞘治疗结石梗阻合并感染的效果显著,具有较高的结石清除率和较低的并发症发生率。Objective:To explore the effectiveness and safety of using a flexible ureteroscopy with a deflectable negative pressure suction sheath for treating stone obstruction complicated with infection.Method:A total of 100 patients with ureteral stone obstruction combined with infections treated in People's Hospital of Ruijin City from January 2022 to December 2023 were included in this study.They were randomly divided into a control group(n=50)and an experimental group(n=50)through computer-generated random codes.The control group received a treatment protocol combining flexible ureteroscopy with a standard ureteroscope sheath,whereas the experimental group was treated with flexible ureteroscopy combined with a front-end bendable negative pressure aspiration sheath.Clinical efficacy,one-time stone clearance rate,surgical indicators,serum markers[procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and C reactive protein(CRP)]1 day before and 2 weeks after surgery and complications within 2 weeks of treatment were compared between the two groups.Result:The overall clinical efficacy and one-time stone clearance rate in the experimental group were significantly higher than those in the control group(P<0.05).The surgical time and hospitalization time of the experimental group were shorter than those of the control group,and the intraoperative bleeding was less than that of the control group,with significant differences(P<0.05).Two weeks postoperatively,levels of PCT,TNF-αand CRP decreased in both groups,those in the experimental group were lower than those in the control group,with significant differences(P<0.05).Within 2 weeks post-surgery,the complication rate in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion:Flexible ureteroscopy combined with a front-end bendable negative pressure aspiration sheath significantly improves the treatment outcomes of stone obstruction combined with infection,offering a higher stone clearance rate and a lower complication rate.

关 键 词：输尿管软镜 可弯曲负压吸引鞘 结石梗阻 感染 安全性 

分 类 号：R699[医药卫生—泌尿科学]