双通道输尿管软镜与电子输尿管软镜行碎石手术的比较研究

Comparison of double-channel flexible ureteroscopy and electronic flexible ureteroscopy for lithotripsy

摘要:

目的??探讨比较双通道输尿管软镜与电子输尿管软镜在行碎石手术时的碎石效率及安全性。方法?收集2007年4月-2016年7月行输尿管软镜钬激光碎石的病例共836例，随机分为电子输尿管软镜组427例和双通道输尿管软镜组409例，比较两组在手术时间、成功率、并发症和残石率等方面的差异。结果?电子输尿管软镜组手术成功率为92.5%，双通道输尿管软镜组手术成功率为83.6%，两组患者之间存在明显差异（P <0.05）；术后电子输尿管软镜组有10例出现全身炎症反应综合征（SIRS），而双通道输尿管镜组有13例出现SIRS，治疗后均好转，差异无统计学意义（P >0.05）；电子输尿管软镜组手术时间为（83.1± 7.9）min，双通道输尿管镜组手术时间为（95.3±7.6）min，电子输尿管软镜组手术用时较短（P <0.05）；电子输尿管软镜组有17例发生石街形成、6例结石残留，体外冲击波碎石术（ESWL）治疗均排空。双通道输尿管软镜术后有25例发生石街形成、8例结石残留，ESWL治疗后均排空，差异均无统计学意义（P >0.05）。结论?双通道输尿管软镜与电子输尿管软镜行碎石手术都是安全有效的手术方式。电子输尿管软镜由于清晰度高、操作灵活，手术成功率高于双通道输尿管软镜。

Abstract:

Objective?To compare the efficiency and safety of double-channel flexible ureteroscopy and electronic flexible ureteroscopy.?Methods?From April 2007 to 2016 July, clinical data of 836 cases flexible ureteroscopic holmium laser lithotripsy were collected. All the patients were randomly divided into electronic flexible ureteroscopy group (n = 427) and double-channel flexible ureteroscopy group (n = 409), the operation time, success rate of surgery, complications, residual stone rate of the two groups were compared.?Results?The success rate of surgery was 92.5% and 83.6% of the two groups respectively, the difference was significant (P < 0.05); postoperative systemic inflammatory response syndrome (SIRS) were occurred in 10 cases and 13 cases respectively, which were cured and the difference was not statistically significant (P > 0.05); the average operation time was (81.1 ± 7.9) min and (95.3 ± 7.6) min respectively, the difference was significant (P < 0.05); The formation of stone street of electronic flexible ureteroscopy group and double-channel flexible ureteroscopy group were 17 cases and 25 cases. The residual stone rate of electronic flexible ureteroscopy group and double-channel flexible ureteroscopy group were 6 cases and 8 cases, of them were cleared after extracorporeal shockwave lithotrips (ESWL). There were no difference between the two groups (P > 0.05).?Conclusion?Both double-channel flexible ureteroscopy and electronic flexible ureteroscopy are effective and safe therapeutic modalities. Electronic flexible ureteroscopy is better than double-channel flexible ureteroscopy in success rate of surgery because of its high definition and flexible operation.