三种输尿管软镜鞘联合输尿管软镜治疗肾结石的效果  

Effect of Three Kinds of Flexible Ureteral Lens Sheath Combined with Flexible Ureteroscope in the Treatment of Renal Calculi

作　　者：张海峰 叶韬[1] 刘启航 张文圣[1] 高加胜[1] ZHANG Haifeng;YE Tao;LIU Qihang;ZHANG Wensheng;GAO Jiasheng(Department of Urology,Jiujiang NO.1 People's Hospital,Jiujiang 332000,China;不详)

机构地区：[1]九江市第一人民医院泌尿外科,江西九江332000

出　　处：《中国医学创新》2024年第28期69-74,共6页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202410632)。

摘　　要：目的:探讨对比三种输尿管软镜鞘联合输尿管软镜治疗肾结石的效果。方法:选取2022年1月—2023年11月九江市第一人民医院收治的90例肾结石患者,按随机数字表法分为A组、B组、C组,各30例。A组采用输尿管软镜和普通输尿管软镜鞘钬激光碎石术治疗,B组采用输尿管软镜和负压吸引鞘钬激光碎石术治疗,C组采用输尿管软镜和可弯曲负压吸引鞘钬激光碎石术治疗。比较三组手术相关指标、感染指标、肾功能指标、结石清除率及不良反应发生率。结果:C组手术时间短于A组、B组,术中出血量少于A组、B组,且B组手术时间短于A组,术中出血量少于A组,差异均有统计学意义(P<0.05);三组术后肾盂输尿管损伤率比较,A组最高,差异有统计学意义(P<0.05)。术后2 h,三组白细胞、降钙素原水平均高于术前,但C组均低于A组、B组,差异均有统计学意义(P<0.05)。术后1 d,C组尿素氮、肌酐水平均低于A组、B组,差异均有统计学意义(P<0.05)。术后1 d,三组结石清除率比较,C组最高,差异有统计学意义(P<0.05)。C组不良反应总发生率低于A组、B组,差异均有统计学意义(P<0.05)。结论:相比普通输尿管软镜鞘和负压吸引鞘,可弯曲负压吸引鞘钬激光碎石术治疗肾结石的效果更好,可缩短手术时间,提高结石清除率,减轻炎症反应,对肾盂输尿管及肾脏功能损伤更小,且术后不良反应发生率更低。Objective:To compare the effect of three kinds of flexible ureteral lens sheath combined with flexible ureteroscope in the treatment of kidney stones.Method:A total of 90 patients with kidney stones admitted to Jiujiang NO.1 People's Hospital from January 2022 to November 2023 were selected and divided into group A,group B and group C according to random number table method,with 30 cases each.Group A was treated with flexible ureteroscope and holmium laser lithotripsy with common flexible ureteroscope sheath,group B was treated with flexible ureteroscope and holmium laser lithotripsy with negative pressure aspiration sheath,and group C was treated with flexible ureteroscope and holmium laser lithotripsy with flexible negative pressure aspiration sheath.Operation related indexes,infection indexes,renal function indexes,stone clearance rate and incidence of adverse reactions were compared among three groups.Result:The operative time of group C was shorter than that of group A and group B,and the intraoperative blood loss was less than that of group A and group B,and the operative time of group B was shorter than that of group A,and the intraoperative blood loss was less than that of group A,the differences were statistically significant(P<0.05).There was significant difference in the rate of renal pelvis and ureteral injury among the three groups,group A was the highest(P<0.05).At 2 h after operation,the average WBC and raw calcitonin water in three groups were higher than those before operation,but those in group C were lower than those in group A and group B,the differences were statistically significant(P<0.05).At 1 d after operation,the levels of urea nitrogen and creatinine in group C were lower than those in group A and group B,the differences were statistically significant(P<0.05).At 1 d after operation,the difference of stone clearance among three groups was statistically,group C was the highest significant(P<0.05).The total incidence of adverse reactions in group C was lower than that in group A and group

关 键 词：输尿管软镜鞘 输尿管软镜 肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]