掺铥激光联合头部可弯曲负压鞘治疗2~3 cm肾结石的临床研究  

Clinical Study of Thulium-Doped Laser Combined with a Flexible Ureteroscope with Distal Negative Pressure Sheath for the Treatment of 2-3 cm Renal Stones

作　　者：鲁文龙 王忠 刘峰 陈琳 Lu Wenlong;Wang Zhong;Liu Feng;Chen Lin(Department of Urology,Shanghai Fengxian District Central Hospital,Shanghai 201400,China)

机构地区：[1]上海市奉贤区中心医院泌尿外科,上海201400

出　　处：《微创泌尿外科杂志》2024年第6期378-382,共5页Journal of Minimally Invasive Urology

基　　金：上海市奉贤区科学技术委员会课题(20241315)。

摘　　要：目的:探讨掺铥激光联合头部可弯曲负压鞘输尿管软镜碎石取石术治疗2~3 cm肾结石的安全性和有效性。方法:选取上海市奉贤区中心医院2023年11月至2024年6月收治的60例2~3 cm肾结石患者,随机分为实验组(30例)和对照组(30例)。实验组采用掺铥激光联合头部可弯曲负压鞘输尿管软镜碎石取石术,对照组采用钬激光经皮肾镜碎石取石术。对比两组手术时间、术后并发症发生率、住院时间、结石清除率等指标。结果:实验组手术时间[(82.2±17.3)min]高于对照组[(52.5±9.7)min]、术后并发症发生率[10%(3/30)]及住院时间[(3.9±0.9)d]明显低于对照组[分别为36.67%(11/30)、(6.7±1.5)d],均P<0.05;两组结石清除率比较差异无统计学意义(P>0.05)。结论:与传统的钬激光经皮肾镜碎石取石术相比,掺铥激光联合头部可弯曲负压鞘输尿管软镜碎石取石术治疗2~3 cm肾结石创伤更小、并发症更少,是一种安全、有效的治疗选择,值得推广应用。Objective:To investigate the safety and efficacy of thulium-doped laser combined with a flexible ure⁃teroscope with a distal flexible negative pressure sheath for the treatment of 2-3 cm renal stones.Methods:Sixty pa⁃tients with 2-3 cm renal stones,admitted to Fengxian District Central Hospital,Shanghai,from November 2023 to June 2024,were randomly divided into two groups:the experimental group(30 cases)and the control group(30 cas⁃es).The experimental group underwent thulium-doped laser combined with a flexible ureteroscope with a distal flexi⁃ble negative pressure sheath for lithotripsy and stone removal,while the control group underwent holmium laser per⁃cutaneous nephrolithotomy.The surgical time,incidence of postoperative complications,length of hospital stay,and stone clearance rate were compared between the two groups.Results:The surgical time in the experimental group[(82.2±17.3)min]was longer than in the control group[(52.5±9.7)min].The incidence of postoperative com⁃plications[10%(3/30)]and the length of hospital stay[(3.9±0.9)days]were significantly lower in the experi⁃mental group compared to the control group[36.67%(11/30),(6.7±1.5)days],with all differences being statisti⁃cally significant(P<0.05).There was no significant difference in the stone clearance rate between the two groups(P>0.05).Conclusion:Compared with traditional holmium laser percutaneous nephrolithotomy,thulium-doped laser combined with a flexible ureteroscope with a distal flexible negative pressure sheath for treating 2-3 cm renal stones results in less trauma,fewer complications,and is a safe and effective treatment option that is worth promoting.

关 键 词：掺铥激光 头部可弯曲负压鞘 输尿管软镜 经皮肾镜 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]