导引鞘在输尿管软镜治疗输尿管中上段嵌顿性结石中的作用
The Role of the Introducer Sheath in the Treatment of Embedded Stones in the Upper and Middle Ureter by Flexible Ureteroscopy
罗庆华 1曹雷华 1涂红坚1
作者信息
- 1. 南昌市第三医院泌尿外科 江西 南昌 330009
- 折叠
摘要
目的:探讨导引鞘在输尿管软镜治疗输尿管中上段嵌顿性结石中的作用.方法:本研究将南昌市第三医院 2021 年 3 月—2023 年 3 月收治的输尿管中上段嵌顿性结石患者 91 例作为研究对象,对患者的治疗方法进行回顾性分析,并按治疗方式的不同分为导引鞘组 46 例,无导引鞘组 45 例.导引鞘组采用有导引鞘的输尿管软镜治疗,无导引鞘组用无导引鞘的输尿管软镜治疗.比较两组临床指征、手术并发症、输尿管损伤及疼痛评分.结果:两组手术时间、住院时间、术后结石清除率、手术成功率比较,差异均无统计学意义(P>0.05).导引鞘组输尿管损伤率为 10.87%,与无导引鞘组输尿管损伤率13.33%比较,差异无统计学意义(P>0.05).两组术后各时段视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05).导引鞘组并发症发生率为 8.70%,显著低于无导引鞘组的 26.67%,差异有统计学意义(x2=3.904,P=0.048).结论:有或没有导引鞘的输尿管软镜在输尿管中上段嵌顿性结石中的治疗临床效果并无显著差别,其中置入导引鞘不会增加输尿管损伤,同时对患者疼痛的加剧无影响,并且相较于无导引鞘,有导引鞘的治疗可显著降低术后并发症.
Abstract
Objective:To explore the role of the introducer sheath in the treatment of embedded stones in the upper and middle ureter with flexible ureteroscopy.Method:In this study,91 patients with embedded stones in the middle and upper ureter admitted to the Third Hospital of Nanchang from March 2021 to March 2023 were taken as the study subjects,and the treatment methods of the patients were retrospectively analysed,and divided into 46 cases in the introducer sheath group and 45 cases in the without introducer sheath group according to the different treatment modalities.The introducer sheath group was treated by flexible ureteroscopy with introducer sheath,and the without introducer sheath group was treated by ureteral the without introducer sheath group was treated with a flexible ureteroscopy without a guiding sheath.Clinical indications,surgical complications,ureteral injury and pain scores were compared between the two groups.Result:There were no differences between the two groups in terms of operation time,hospital stay,postoperative stone removal rate,and surgical success rate,the differences were not statistically significant(P>0.05).The ureteral injury rate in the introducer sheath group was 10.87%compared to 13.33%in the without introducer sheath group,the difference was not statistically significant(P>0.05).There were no statistically significant differences in visual analogue scale(VAS)scores between the two groups at different postoperative stages(P>0.05).The incidence of complications in the introducer sheath group was 8.70%,which was lower than 26.67%in the without introducer sheath group,the difference was statistically significant(x2=3.904,P=0.048).Conclusion:There is no significant difference in the clinical outcome of flexible ureteroscopy with or without a introducer sheath in the treatment of upper and middle ureter embedded stone,in which the placement of a introducer sheath does not increase ureteral injury,has no effect on the exacerbation of pain in patients,and significantly reduced postoperative complications with the introducer sheath compared without introducer sheath.
关键词
导引鞘/输尿管软镜/输尿管中上段/嵌顿性结石Key words
Introducer sheath/Flexible ureteroscopy/Upper and middle ureter/Embedded stone引用本文复制引用
基金项目
江西省卫生健康委科技计划项目(202140066)
出版年
2024
国家科技期刊平台
NSTL
万方数据