Objective To exploring the feasibility and effectiveness analysis of using ureteral hard endoscopy to treat small ureteral stones(<1 cm)in the upper segment of the ureter in grassroots hospitals,in response to the current national DRG/DIP medical insurance payment policy.Methods From 2021 to 2022,15 cases of upper ureteral calculi underwent rigid ureteroscopic pneumatic lithotripsy with new lithotomy position in our department,and the results were retrospectively analyzed.Steps:The new lithotomy position was set:the affected side of the patient had a high lumbar cushion,the opposite side(healthy side)placed the lateral decubitus baffle.The operating table was tilted to the healthy side,with slightly higher head and lower feet.As well as ureteroscopy approached the calculi,the calculi were locked with a stone net basket in time,and the calculi were broken by pneumatic trajectory,and the larger calculi were removed.Postoperative analysis of operation time,operation cost,length of stay and other indicators compared with the control group(soft ureteroscope or percutaneous nephrolithotripsy).Results There were 8 males and 7 females.Average age was(47.30±14.20)years.There were left side in 8 cases and right side in 7 cases.The average diameter of calculi was(0.87±0.25)cm.All patients were successfully operated.The operation time was(26.50±18.25)min,the hospital stay was(2.00±0.50)days,and the operation cost was(1.10±0.12)ten thousand yuan,which were statistically significant compared with the control group.Conclusion Hard ureteroscopy with new lithotomy position for the treatment of upper ureteral calculi has high probability of capturing calculi,good lithotriptic effect,safe and reliable operation,low treatment cost and quick recovery.
New lithotomy positionUpper ureteral calculiPneumatic lithotripsy
万方数据
维普
