摘要
目的 探究不同程度肾积水条件下输尿管软镜钬激光碎石联合负压吸引工作鞘治疗肾结石的有效性和安全性.方法 回顾性分析2019年8月至2021年12月在本院接受输尿管软镜联合负压吸引工作鞘治疗的135例肾结石患者的临床资料.根据肾积水严重程度分为无肾积水组(56例)、轻度肾积水组(28例)、中度肾积水组(27例)和重度肾积水组(24例).收集患者的年龄、性别、合并症、结石特征、手术时间、结石清除率(SFR)、围手术期并发症发生率等,比较不同肾积水程度患者间的术前和术后指标的差异.结果 四组患者的手术时间、术后1 d、1个月SFR、套石栏使用比较,差异均有统计学意义(均P＜0.05).重度肾积水组患者的手术时间明显较长,术后1 d的SFR较低[62.5％(15/24)],术后1个月的SFR较低[79.1％(19/24)],套石篮的使用数明显升高.四组的并发症发生率比较,差异无统计学意义(P＞0.05).结论 输尿管软镜联合负压吸引工作鞘在治疗肾轻中度积水合并肾结石中安全有效,在重度肾积水情况下手术效果欠佳.
Abstract
Objective To investigate the efficacy and safety of ureteroscopic holmium laser lithotripsy combined with negative pressure suction working sheath in the treatment of renal calculi un-der different degrees of hydronephrosis.Methods The clinical data of 135 patients with kidney stones who received ureteroscopy combined with negative pressure suction working sheath treatment in our hospital from August 2019 to December 2021 were retrospectively analyzed.According to the severity of hydronephrosis,patients were divided into non-hydronephrosis group(56 cases),mild hydrone-phrosis group(28 cases),moderate hydronephrosis group(27 cases)and severe hydronephrosis group(24 cases).Age,gender,complications,stone characteristics,operative time,stone clearance rate(SFR),perioperative complication rate and so on were collected.The preoperative and postoperative indexes of patients with different degrees of hydronephrosis were compared.Results There were statis-tically significant differences in operation time,SFR 1 day and 1 month after operation and the use of Taishilan among the four groups(all P＜0.05).The operative time of patients with severe hydrops was significantly longer,the stone clearance rate was lower 1 day after surgery[62.5％(15/24)],and the stone clearance rate was lower 1 month after surgery[79.1％(19/24)],and the number of stone basket used was significantly increased.There was no significant difference in the incidence of complications among the four groups(P＞0.05).Conclusions Ureteroscopy combined with negative pressure suction working sheath is safe and effective in the treatment of mild to moderate hydronephro-sis complicated with renal calculi,and the surgical effect is not good in severe hydronephrosis.
基金项目
山西省基础研究计划(202103021224403)
山西医科大学第一医院"精准医疗"重点创新培育团队项目(202103021224403)
NETL
NSTL
维普
万方数据