摘要
目的 探究细、粗半硬性输尿管镜应用于输尿管上段结石手术中的治疗效果.方法 选取2021年9月至2022年10月正生医生集团11个临床中心收治的917例输尿管上段最大径线6～12 mm结石患者作为研究对象,根据使用不同输尿管镜将患者分为细镜组(n=502)与粗镜组(n=415)进行钬激光碎石治疗.细镜组采用F6.0/7.5输尿管镜,粗镜组采用F8.0/9.8输尿管镜.比较两组是否成功上镜、上镜难易、黏膜损伤程度、碎石取石效果、手术时间、置管未碎石、改用软镜、并发症发生情况.结果 两组是否成功上镜、上镜难易、黏膜损伤程度比较,差异有统计学意义(P＜0.01);两组碎石取石效果、手术时间、置管未碎石、改用软镜比较,差异无统计学意义(P＞0.05).细镜组并发症发生率低于粗镜组,差异无统计学意义(P＞0.05).结论 细输尿管镜治疗输尿管上段结石在上镜、损伤等方面应用效果较好,适合大多数患者,特别是中、小结石应优先考虑采用细镜实施手术.
Abstract
Objective To explore the therapeutic effect of fine and thick semi-rigid ureteroscope in the operation of upper ureteric calculi.Methods A total of 917 patients with upper ureteral stones of 6-12 mm in maximum diameter admitted to 11 clinical centers of Zhensheng Medical Group from September 2021 to October 2022 were selected as the observation objects.The patients were divided into fine microscope group(n=502)and thick microscope group(n=415)according to different ureteroscopy for holmium laser lithotripsy.The fine ureteroscope group used F6.0/7.5 ureteroscopes and the thick ureteroscope group used F8.0/9.8 ureteroscopes.The two groups were compared whether successful on ureteroscope insertion,the difficulty of insertion,the degree of mucosal injury,the effect of lithotripsy,operation time,catheterization without lithotripsy,conversion to flexible ureteroscope,and the occurrence of complications.Results The differences in whether successful on ureteroscope insertion,the difficulty of insertion and the degree of mucosal injury between the two groups were significant(P＜0.01).There were no significant differences in the effect of lithotripsy,operation time,catheterization without lithotripsy and conversion to flexible ureteroscope between the two groups(P＞0.05).The complication rate in the fine ureteroscope group was lower than that in the thick ureteroscope group,but there was no significant difference(P＞0.05).Conclusions Fine ureteroscope is more effective in the treatment of upper ureteral calculi in many aspects such as ureteroscope insertion and injury,and is suitable for most cases.In particular,fine ureteroscope should be given priority to medium and small calculi.
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