Advantages and experience of holmium laser lithotripsy in lower ureteral calculi as day operation
-
摘要: 总结输尿管下段结石钬激光碎石作为日间手术的优势与体会。选取2019年11月—2020年10月行钬激光碎石+支架管置入术治疗输尿管下段结石患者50例，将患者随机纳入日间手术组与常规手术组，日间手术组利用日间手术运行模式实施输尿管镜下钬激光碎石术，常规手术组利用传统住院模式实施输尿管镜下钬激光碎石术，比较2组术前等待时间、住院时间、结石清除率、术后并发症和住院费用等指标。日间手术组术前等待时间明显少于常规手术组[(27±6) h vs.(72±11) h，P< 0.05]。日间手术组住院时间明显少于常规手术组[(38±9) h vs.(96±25) h，P< 0.05]。日间手术组住院费用明显低于常规手术组[(10 443±1302)元vs.(16 523±2347)元，P< 0.05]。2组结石清除率(91.4% vs. 91.8%，P>0.05)和术后并发症发生率(4.3% vs. 0，P>0.05)比较差异无统计学意义，在手术安全性及治疗效果方面无差异，皆安全可行。输尿管下段结石钬激光碎石开展日间手术安全可行，具有住院时间短、医疗费用低、治疗效果确切等优点，是一种高效安全的治疗模式，值得积极推广。Abstract: To summarize the advantages and experience of holmium laser lithotripsy in lower ureteral calculi as Day Operation. A total of 50 patients with lower ureteral calculi treated in our hospital from November 2019 to October 2020 were randomly divided into Day Operation group and routine operation group. The Day Operation group was treated with holmium laser lithotripsy under ureteroscope, while the routine operation group was treated with holmium laser lithotripsy under ureteroscope by traditional hospitalization mode. s: The waiting time before operation of Day Operation group was significantly shorter than that of the routine group [(27±6) h vs.(72±11) h,P< 0.05]. The length of hospital stay in Day Operation group was significantly shorter than that in routine group [(38±9) h vs. (96±25) h,P< 0.05]. Hospitalization cost of Day Operation group was significantly lower than that of routine operation group [(10 443±1302) yuan vs. (16 523±2347) yuan,P< 0.05]. However, there was no significant difference in stone clearance rate (91.4% vs. 91.8%,P> 0.05) or postoperative complication rate (4.3% vs. 0,P> 0.05) between the two groups. Also, there was no difference in surgical safety or therapeutic effect, so both treatment modes were safe and feasible. Holmium laser lithotripsy for lower ureteral calculi as Day Operation is safe and feasible, and has the advantages of short hospitalization time, low medical expenses and accurate treatment effect. It is an efficient and safe treatment mode, so it is worthy of active promotion.
-
Key words:
- lower ureteral calculi /
- holmium laser lithotripsy /
- day operation
-
-
表 1 2组患者相关指标比较
X±S 指标 日间手术组
(n=23)常规手术组
(n=27)手术等待时间/h 27±6 72±11 住院时间/h 38±9 96±25 结石清除率/% 91.4 91.8 住院费用/元 10 443±1302 16 523±2347 并发症发生率/% 4.3 0 
下载: 导出CSV
-
[1] Roberts L. Day surgery-National and international: From the past to the future[J]. Ambulatory Surgery, 2006, 12(3): 143-145. doi: 10.1016/j.ambsur.2005.02.002
[2] Suhonen RA, Iivonen MK, Vlimki MA. Day-casesurgery patients health-related quality of life[J]. Int J Nurs Pract, 2007, 13(2): 121-129. doi: 10.1111/j.1440-172X.2007.00610.x
[3] 曾国华, 麦赞林, 夏术阶, 等. 中国成年人群尿石症患病率横断面调查[J]. 中华泌尿外科杂志, 2015, 36(7): 528-532. doi: 10.3760/cma.j.issn.1000-6702.2015.07.014
[4] Resorlu B, Unsal A, Ziypak T, et al. Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones[J]. World J Urol, 2013, 31(6): 1581-1586. doi: 10.1007/s00345-012-0991-1
[5] Boudreaux AM, Simmons JW. Prehabilitation and Optimization of Modifiable Patient Risk Factors: The Importance of Effective Preoperative Evaluation to Improve Surgical Outcomes[J]. AORN J, 2019, 109(4): 500-507. doi: 10.1002/aorn.12646
[6] Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory Surgery Data From Hospitals and Ambulatory Surgery Centers: United States, 2010[J]. Natl Health Stat Report, 2017, (102): 1-15.
[7] 白雪, 马洪升, 罗利. 中外日间手术发展对比研究及展望[J]. 中国医院管理, 2014, 34(5): 35-37. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGL201405018.htm
[8] Zhong W, Leto G, Wang L, et al. Systemic inflammatory response syndrome after nexible ureteroscopic lithotripsy: a study of risk factors[J]. J Endourol, 2015, 29(1): 25-28. doi: 10.1089/end.2014.0409
[9] 范永保, 沈文, 吴义高, 等. 输尿管结石微创术后感染性发热危险因素分析[J]. 临床泌尿外科杂志, 2021, 36(11): 897-899. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202111013.htm
[10] Sui W, Theofanides MC, Matulay JT, et al. Utilization of Preoperative Laboratory Testing for Low-risk, Ambulatory Urologic Procedures[J]. Urology, 2016, 94: 77-84. doi: 10.1016/j.urology.2016.03.053
[11] 冀冰心, 李小莹, 张艳红, 等. 日间病房病种准入与病案模板化管理[J]. 中国病案, 2016, 17(11): 16-18. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGBN201611006.htm
[12] Zylstra J, Boshier P, Whyte GP, et al. Peri-operative patient optimization for oesophageal cancer surgery-From prehabilitation to enhanced recovery[J]. Best Pract Res Clin Gastroenterol, 2018, 36-37: 61-73. doi: 10.1016/j.bpg.2018.11.006
-