NTrap网篮联合输尿管软镜钬激光术治疗上段输尿管结石的效果及预后观察  

Effect and prognosis of NTrap net basket combined with flexible ureteroscopic lithotripsy in treatment of upper calculus of ureter

作　　者：郭志新 王俊 余晓 关天佑 于芳芳 GUO Zhi-xin;WANG Jun;YU Xiao;GUAN Tian-you;YU Fang-fang(Department of Urology,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian,Henan 463000,China)

机构地区：[1]驻马店市中医院泌尿外科,河南驻马店463000

出　　处：《医药论坛杂志》2024年第16期1703-1707,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20221062)。

摘　　要：目的探讨NTrap网篮联合输尿管软镜钬激光术(flexible ureteroscopic lithotripsy,FURL)治疗上段输尿管结石(calculus of ureter,CU)的临床有效性及安全性。方法选取2020年1月—2022年5月驻马店市中医院行FURL手术治疗的106例CU患者,采用随机数表法分为研究组(采用NTrap网篮联合FURL治疗)和对照组(单独采用FURL治疗)各53例。比较两组手术一般情况和一次性碎石成功率、结石上移率、30 d结石清除率;比较两组术前和术后7 d血清尿素氮(blood urea nitrogen,BUN)、血肌酐(creatinine,Cr)和C反应蛋白(C-reactive protein,CRP)及肿瘤坏死因子(tumor necrosis factor-α,TNF-α)水平;比较两组术后并发症发生率和术后6个月、1年的结石复发率。结果研究组住院费用高于对照组(P<0.05);研究组一次性碎石成功率和30 d结石清除率分别为94.34%和96.23%,高于对照组的81.13%和79.25%,结石上移率为1.89%,低于对照组的16.98%(P<0.05);研究组术后7 d BUN、Cr和CRP、TNF-α水平低于对照组(P<0.05);研究组术后并发症发生率为11.32%,低于对照组的26.42%(P<0.05);研究组术后6个月和术后1年的复发率为1.89%和3.77%,低于对照组的9.30%和13.21%(P<0.05)。结论NTrap网篮联合FURL可有效提高CU患者结石清除效果,降低复发风险,提高手术安全性。Objective To explore the clinical effectiveness and safety of NTrap net basket combined with flexible ureteroscopic lithotripsy(FURL)in the treatment of upper calculus of ureter(CU).Methods A total of 106 patients with CU undergoing FURL in Zhumadian Hospital of Traditional Chinese Medicine were enrolled between January 2020 and May 2022.According to random number table method,they were divided into study group(NTrap net basket combined with FURL)and control group(FURL),53 cases in each group.The general conditions of operation,success rate of one time lithotripsy,stone up-shift rate and 30 d stone clearance rate,levels of serum blood urea nitrogen(BUN),creatinine(Cr),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)before surgery and at 7d after surgery,incidence of postoperative complications and stones recurrence rates at 6 months and 1 year after surgery were compared between the two groups.Results The hospitalization cost in study group was higher than that in control group(P<0.05).The success rate of one-time lithotripsy and 30d stone clearance rate in study group were 94.34%and 96.23%,higher than those in control group(81.13%,79.25%),while stone up-shift rate was lower than that in control group(1.89%vs 16.98%,P<0.05).At 7 d after surgery,levels of BUN,Cr,CRP and TNF-αin study group were lower than those in control group(P<0.05).The incidence of postoperative complications in study group was lower than that in control group(11.32%vs 26.42%,P<0.05).At 6 months and 1 year after surgery,recurrence rates in study group were 1.89%and 3.77%,lower than those in control group(9.30%,13.21%,P<0.05).Conclusion NTrap net basket combined with FURL can effectively improve stone clearance effect in CU patients,with low recurrence risk and high surgical safety.

关 键 词：NTrap网篮 输尿管软镜钬激光术 上段输尿管结石 手术效果 预后 

分 类 号：R699[医药卫生—泌尿科学]