输尿管专用球囊扩张器在上尿路结石合并输尿管狭窄治疗中的应用体会  

Application of ureteral balloon dilator in the treatment of upper urinary tract calculi combined with ureteral stricture

作　　者：李培华 陈苗 韩德平 宋士强 LI Peihua;CHEN Miao;HAN Deping(Department of Urology,Qingdao Chengyang People's Hospital,Qingdao 266109,China)

机构地区：[1]青岛市城阳区人民医院泌尿外科,山东青岛266109

出　　处：《腹腔镜外科杂志》2024年第12期931-935,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨输尿管专用球囊扩张器在一期处理上尿路结石合并输尿管狭窄中的应用疗效。方法:回顾性选取2021年3月至2023年3月收治的58例上尿路结石合并输尿管狭窄患者,根据手术方式分为对照组与实验组,对照组(n=26)一期留置双J管,0.5~1个月后二期治疗结石;实验组(n=32)一期即使用输尿管专用球囊扩张输尿管狭窄段、输尿管硬镜或软镜治疗结石。对比分析两组麻醉时间、手术时间、术后胃肠功能恢复时间、住院时间、手术满意率、重置双J管率、术后3个月与6个月治愈率等相关指标。结果:实验组麻醉时间、手术时间短于对照组,重置双J管率低于对照组,手术满意率高于对照组,差异有统计学意义(P<0.05);两组术后胃肠功能恢复时间、住院时间及术后3个月、6个月治愈率差异无统计学意义(P>0.05)。结论:经输尿管镜下输尿管狭窄专用球囊扩张器一期治疗上尿路结石合并输尿管狭窄安全、有效,手术时间短,手术次数减少,重复留置双J管率低,患者满意度高,疗效可靠,值得临床推广。Objective:To evaluate the effectiveness of the ureteral balloon dilator in the primary management of upper urinary tract calculi with ureteral stricture.Methods:A retrospective review was conducted on 58 patients with upper urinary tract calculi and ureteral stricture who underwent surgery from Mar.2021 to Mar.2023.Patients were categorized into a control group and an experimental group based on the surgical approach.The control group consisted of 26 patients who received a one-stage double-J stent placement followed by a two-stage calculi treatment approximately 0.5-1 month later.The experimental group included 32 patients treated with a one-stage ureteral stricture dilation using a specialized balloon dilator and subsequent ureteroscopy or flexible ureteroscopy for calculi management.The anesthesia duration,surgical time,postoperative gastrointestinal recovery time,hospital stay,surgical satisfaction,dou-ble-J stent repositioning rates,cure rates at 3 months and 6 months after surgery were compared and analyzed between the two groups.Results:Anesthesia and surgical time were shorter in the experimental group than those in the control group,the rate of double-J stent repositioning was lower in the experimental group than that in the control group,surgical satisfaction was greater in the experimental group than the control group,with significant differences between the two group(P<0.05).There were no significant differences in postoperative gastrointestinal recovery time,hospital stay and cure rates at 3 months and 6 months after surgery between the two groups(P>0.05).Conclusions:The use of a ureteral balloon dilator for the initial treatment of upper urinary tract calculi with ureteral stricture is both safe and effective.It offers advantages such as reduced surgical time,fewer procedures,a lower rate of double-J stent repositioning,higher patient satisfaction,and reliable efficacy,making it a promising approach for clinical promotion.

关 键 词：上尿路结石 输尿管球囊扩张器 输尿管狭窄 疗效比较研究 

分 类 号：R691.4[医药卫生—泌尿科学]