前段可弯曲负压吸引鞘联合一次性输尿管软镜治疗HALF分组高危组患者术后感染相关并发症的研究  

Study on the treatment of postoperative infectious complications in HALF group of high-risk patients with tip-flexible negative pressure ureteral access sheath combined with disposable ureteroscope

作　　者：胡一帆 吕远[1] 张豪放 徐进 胡锦浩 许长宝[1] HU Yifan;LV Yuan;ZHANG Haofang;XU Jin;HU Jinhao;XU Changbao(Department of Urology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China)

机构地区：[1]郑州大学第二附属医院泌尿外科,郑州450000

出　　处：《临床泌尿外科杂志》2025年第1期53-57,共5页Journal of Clinical Urology

摘　　要：目的:探讨在治疗HALF高危组上尿路结石患者的输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FURL)术中应用前段可弯负压吸引鞘对术后感染相关并发症的影响。方法:回顾性分析2022年3月—2024年2月在郑州大学第二附属医院行FURL的128例HALF分组高危组上尿路结石患者的临床资料。根据术中是否使用负压鞘分为负压组(76例)和普通组(52例)。统计所有患者的基本资料、手术相关资料、术后感染相关并发症发生率等数据。比较2组患者术后感染指标、术后感染相关并发症发生率、术后住院时长、术后抗菌药物使用时长等。结果:所有手术均一期顺利完成。2组患者的临床基本资料差异无统计学意义。负压组手术时间[60.00(45.00,85.00)min]与普通组[55.00(40.00,73.75)min]比较差异无统计学意义。负压组术后发热1例(1.3%)、全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)2例(2.6%)、术后住院时间(2.75±1.26)d、术后抗菌药物应用时间(2.42±1.10)d,均低于普通组的6例(11.5%)、7例(13.5%)、(3.75±2.10)d、(3.50±2.10)d,差异有统计学意义(P<0.05)。结论:在FURL治疗HALF分组高危组患者术中应用前段可弯曲负压吸引鞘可以降低术后感染相关并发症发生率,提高手术的安全性,减少术后抗菌药物应用,节约医疗资源,缩短患者住院时长,促进患者术后恢复,降低患者住院成本。Objective:To explore the effect of flexible ureteroscopic lithotripsy(FURL)with tip-flexible negative pressure ureteral access sheath on postoperative infectious complications in high risk group of HALF.Methods:The clinical data of 128 patients with upper urinary calculi in high risk group of HALF who underwent FURL in the Second Affiliated Hospital of Zhengzhou University from March 2022 to February 2024 were retrospectively analyzed.Based on whether or not tip-flexible negative pressure ureteral access sheath was used during operation,the patients were divide into negative pressure group(76 cases)and normal group(52 cases).The basic data,surgical data and incidence of postoperative infectious complications of all patients were analyzed.Postoperative infection index,incidence rate of postoperative infectious complications,duration of postoperative hospitalization and duration of postoperative antibiotic use were compared between the two groups.Results:All patients successfully completed the primary operation.There was no statistical difference in the basic clinical data between the two groups.There was no significant difference in operation time between the negative pressure group(60.00[45.00,85.00]min)and the normal group(55.00[40.00,73.75]min).There was one case of postoperative fever(1.3%)and two cases of systemic inflammatory response syndrome(2.6%)in the negative pressure group,while there were six cases of postoperative fever(11.5%)and seven cases of systemic inflammatory response syndrome(13.5%)in the conventional group.The postoperative hospital stay(2.75±1.26)days and the duration of antibiotic use(2.42±1.10)days in the negative pressure group were shorter than those in the conventional group(3.75±2.10)days and(3.50±2.10)days,respectively,with statistically significant differences(P<0.05).Conclusion:The use of tip-flexible negative pressure ureteral access sheath in the FURL treatment of the high-risk patients in the HALF group can reduce the incidence of postoperative infectious complications,impro

关 键 词：前段可弯曲负压吸引鞘 输尿管软镜碎石术 术后感染 上尿路结石 

分 类 号：R693[医药卫生—泌尿科学]