Clinical therapeutic effect study of Shuotong ureteroscope combined with flexible ureteroscope in the treatment of upper urinary tract calculi with maximum diameter >10 mm
-
摘要: 目的 分析硕通镜联合输尿管软镜碎石术治疗最大直径>10 mm上尿路结石的临床疗效。方法 回顾性分析2019年1月—2021年11月在东莞市人民医院行腔内镜治疗最大直径>10 mm上尿路结石患者的临床资料，其中行硕通镜联合输尿管软镜碎石术44例(硕通镜联合输尿管软镜碎石组)，行传统输尿管软镜碎石术132例(输尿管软镜碎石组)，比较两组患者的结石清除率、术后感染率、输尿管损伤发生率、住院费用等指标。结果 硕通镜联合输尿管软镜碎石组术后结石清除率为88.64%，高于输尿管软镜碎石组的72.73%；硕通镜联合输尿管软镜碎石组术后感染率为2.27%，低于输尿管软镜碎石组的13.64%；两组比较差异均有统计学意义(P < 0.05)。结论 在腔内镜治疗最大直径>10 mm上尿路结石中，硕通镜联合输尿管软镜碎石术较传统输尿管软镜碎石术具有更高的结石清除率及更低的术后感染率，在临床治疗中值得推广。Abstract: Objective To analyze the clinical effect of Shuotong ureteroscope combined with flexible ureteroscopic lithotripsy in the treatment of upper urinary tract calculi with maximum diameter > 10 mm.Methods The clinical data of patients with upper urinary tract calculi with maximum diameter > 10 mm treated by urinary endoscope in Dongguan People's Hospital from January 2019 to November 2021 were analyzed retrospectively, including 44 cases treated with Shuotong ureteroscope combined with flexible ureteroscopic lithotripsy (Shuotong group) and 132 cases treated with flexible ureteroscopic lithotripsy (FU group). The stone free rate, postoperative infection rate, incidence of ureteral injury and hospitalization expenses of the two groups were compared.Results The stone free rate of Shuotong group was 88.64% higher than 72.73% of the FU group, and the postoperative infection rate of the Shuotong group was 2.27% lower than 13.64% of the FU group. There was significant difference between the two groups (P < 0.05).Conclusion In the endoscopic treatment of upper urinary tract calculi with a maximum diameter > 10 mm, Shuotong ureteroscope combined with flexible ureteroscopic lithotripsy has higher stone free rate and lower postoperative infection rate than flexible ureteroscopic lithotripsy, so it is worthy of promotion in clinical treatment.
-
-
表 表 1 两组患者术前一般资料比较
例(%)，M(Q1，Q3) 项目 硕通镜联合输尿管软镜碎石组(n=44) 输尿管软镜碎石组(n=132) Z/χ2 P值 年龄/岁 54(44，65) 55(39，63) -0.713 0.476 性别 0.486 0.486 男 21(47.70) 71(53.80) 女 23(52.30) 61(46.20) 结石位置 0.016 0.900 肾 26(59.10) 76(58.00) 输尿管上段 18(40.90) 55(42.00) 结石最大直径/mm 16.25(13.15，20.20) 15.24(13.34，20.12) -0.185 0.854 结石最大横切面面积/mm2 140.5(98.00，200.25) 131.5(86.50，185.75) -0.917 0.359 结石CT值/HU 760.0(567.25，1017.00) 721.5(552.50，907.75) -0.786 0.432 肾积液程度 0.083 0.774 轻度 39(88.60) 119(90.20) 中度 5(11.40) 13(9.80) 尿培养阳性 12(27.30) 36(27.30) < 0.001 1.000 尿细菌数量/(个·μL-1) 72.2(13.68，426.00) 34.8(10.80，220.90) -0.822 0.411 尿白细胞数量/(个·μL-1) 178.65(50.65，736.68) 87.60(29.30，389.90) -1.690 0.091 血白细胞计数/(×109·L-1) 6.54(5.70，7.42) 6.78(5.69，8.41) -0.952 0.341 血肌酐/(μmol·L-1) 75.65(65.30，99.68) 72.20(59.45，90.38) -1.245 0.213 合并症 糖尿病 11(25.00) 25(18.90) 0.745 0.388 泌尿系感染 32(72.70) 96(72.70) < 0.001 1.000 
下载: 导出CSV
表 表 2 内镜下输尿管管壁损伤的分级
损伤分级 内镜下表现 低级别 0级 无损伤或仅有黏膜出血点 高级别 1级 黏膜撕脱，但无肌层损伤 2级 损伤累计黏膜层及肌层，但外膜完整，未见输尿管外脂肪 3级 输尿管全层损伤，外膜穿透，输尿管外脂肪可见 4级 输尿管完全断裂
下载: 导出CSV
-
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] -