首页|末端可弯曲输尿管吸引鞘与负压吸引鞘辅助输尿管软镜治疗<2 cm肾结石疗效比较的随机对照研究

末端可弯曲输尿管吸引鞘与负压吸引鞘辅助输尿管软镜治疗<2 cm肾结石疗效比较的随机对照研究

Comparison of flexible terminal suction ureteral access sheath versus negative pressure ureteral access sheath in the treatment of kidney stones with diameter<2 cm

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目的 比较末端可弯曲输尿管吸引鞘(FTS-UAS)和负压吸引鞘在输尿管软镜联合钬激光治疗<2 cm肾结石中的有效性和安全性.方法 选取广东医科大学附属阳江医院2022年11月—2023年8月收治的68例肾结石(结石<2 cm)患者,采用随机数字表法将患者分为可弯鞘组和负压吸引鞘组各34例,比较两组围手术期参数及结石清除率(SFR)等指标.结果 可弯鞘组术后第1天SFR明显高于负压吸引鞘组[85.3%(29/34)vs.61.8%(21/34),P=0.028],手术时间明显短于负压吸引鞘组[(65.85±13.16)min vs.(75.59±20.21)min,P=0.022],肾下盏结石患者术后第 1 天 SFR 较负压吸引鞘组高[82.4%(14/17)vs.43.8%(7/16),P=0.032],差异均有统计学意义.而可弯鞘组和负压吸引鞘组的术后第1个月SFR[94.1%(32/34)vs.85.3%(29/34),P=0.452]、术后血红蛋白下降值、术后血清肌酐值、术后并发症发生率、术后住院时间、住院费用比较,差异均无统计学意义(P>0.05).结论 FTS-UAS辅助输尿管软镜治疗<2 cm的肾结石可提高术后短期SFR并缩短手术时间,安全性和有效性良好,值得在临床上推广.
Objective To compare the safety and efficacy of flexible terminal suction ureteral access sheath(FTS-UAS)and negative pressure ureteral access sheath(NPUAS)in flexible ureteroscopic lithotripsy with holmium laser in treatment of renal calculi less than 2 cm in diameter.Methods A total of 68 patients(largest diameter of stone<2 cm)with renal calculi treated in Yangjiang Hospital Affiliated to Guangdong Medical University during Nov.2022 and Aug.2023 were divided into FTS-UAS group(n=34)and NPUAS group(n=34)according to different surgical methods.The perioperative parameters and stone-free rate(SFR)were compared between the two groups.Results The average SFR on the first day after operation was significantly higher in the FTS-UAS group than in the NPUAS group[85.3%(29/34)vs.61.8%(21/34),P=0.028].The operation time was significantly lower in the FTS-UAS group than in the NPUAS group[(65.85±13.16)min vs.(75.59±20.21)min,P=0.022].For lower calyceal renal calculi,the SFR was significantly higher in the FTS-UAS group than in the NPUAS group[82.4%(14/17)vs.43.8%(7/16),P=0.032].One month after operation,the SFR was higher in the FTS-UAS group than in the NPUAS group[94.1%(32/34)vs.85.3%(29/34),P=0.452].There were no significant differences in hemoglobin reduction,serum creatinine level,postoperative complications,hospital stay and hospitalization costs between the two groups(P>0.05).Conclusion FTS-UAS in flexible ureteroscopic lithotripsy can shorten the operation time and improve stone-clearance rate,which is safe,effective,and worthy of clinical promotion.

flexible ureteroscopic lithotripsyrenal calculiflexible terminal suction ureteral access sheathnegative pressure ureteral access sheathholmium laser lithotripsy

戴建航、肖云新、杨伟明、崔凯旋、张成杰、陈光耀

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广东医科大学第一临床医学院,广东湛江 524023

广东医科大学附属阳江医院泌尿外科,广 东阳江 529500

输尿管软镜 肾结石 末端可弯曲输尿管吸引鞘 负压吸引鞘 钬激光碎石术

2024

现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子:1.106
ISSN:1009-8291
年,卷(期):2024.29(5)
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