输尿管结石处管壁厚度对输尿管镜碎石取石术临床效果的影响  

Effect of ureteral wall thickness at the site of ureteral stones on the clinical efficacy of ureteroscopic lithotripsy

作　　者：蒲伟 季健 吴知达 王亚飞 杨天参 陈旅阳 崔庆鹏 许栩 孙晓磊 朱元全 范世成 PU Wei;JI Jian;WU Zhi-da;WANG Ya-fei;YANG Tian-can;CHEN Lyu-yang;CUI Qing-peng;XU Xu;SUN Xiao-lei;ZHU Yuan-quan;FAN Shi-cheng(Department of Urology,the Third People's Hospital of Yunnan Province/the Second Affiliated Hospital of Dali University,Kunming Yunnan 650011,China)

机构地区：[1]云南省第三人民医院/大理大学第二附属医院泌尿外科,云南昆明650011

出　　处：《局解手术学杂志》2024年第12期1077-1081,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：云南省教育厅科学研究基金项目(2021J0343)。

摘　　要：目的 探讨输尿管结石处不同的输尿管壁厚度(UWT)对输尿管镜碎石取石术(URL)疗效的影响。方法 回顾性分析我院164例输尿管结石患者的临床资料。根据不同UWT,将患者分为轻度增厚组84例(UWT<3.16 mm)、中度增厚组31例(UWT为3.16~3.49 mm)和重度增厚组49例(UWT>3.49 mm),比较3组患者临床相关指标的差异。结果 轻度增厚组、中度增厚组术后肾绞痛及术后白细胞异常发生率均低于重度增厚组,差异有统计学意义(P<0.05)。轻度增厚组、中度增厚组患者术后置管时间均短于重度增厚组,二次碎石、结石残留及结石返肾发生率均低于重度增厚组,差异有统计学意义(P<0.05)。轻度增厚组、中度增厚组患者住院时间及住院费用均短/少于重度增厚组,差异有统计学意义(P<0.05)。结论 随着UWT的增加(特别是UWT>3.49 mm时),URL的术后并发症发生率、住院费用均有不同程度的增加,且手术疗效降低。临床工作中UWT在预测URL的手术疗效及并发症等方面具有潜在价值。Objective To investigate the effect of varying ureteral wall thickness(UWT)at the site of ureteral stones on the clinical efficacy of ureteroscopic lithotripsy(URL).Methods The clinical data of 164 patients with ureteral stones in our hospital were retrospectively analyzed.According to different UWT,the patients were divided into the mild thickening group(84 cases,UWT<3.16 mm),the moderate thickening group(31 cases,UWT 3.16 to 3.49 mm),and the severe thickening group(49 cases,UWT>3.49 mm),and the differences of clinical related indicators among the three groups were compared.Results The incidence of postoperative renal colic and leukocyte disorder in the mild thickening group and the moderate thickening group were lower than those in the severe thickening group,and the differences were statistically significant(P<0.05).The postoperative catheterization time in the mild thickening group and the moderate thickening group were shorter than that in the severe thickening group,and the incidences of secondary lithotripsy,residual stones and stone return to kidney in the mild thickening group and the moderate thickening group were lower than those in the severe thickening group,with statistically significant differences(P<0.05).The length of hospital stay and hospitalization cost in the mild thickening group and the moderate thickening group were shorter/less than those in the severe thickening group,with statistically significant differences(P<0.05).Conclusion With the increase of UWT(especially when UWT>3.49 mm),the incidence of postoperative complications and hospitalization cost of URL increase to varying degrees,and the surgical efficacy decreases.In clinical work,UWT measurement holds potential value in predicting the surgical efficacy and complications of URL.

关 键 词：输尿管结石 输尿管壁厚度 输尿管镜碎石取石术 预测 

分 类 号：R6934[医药卫生—泌尿科学]