应用旁置输尿管导管负压吸引的输尿管硬镜钬激光碎石治疗输尿管上段结石

Application of adjacent ureteral catheter with vacuum suction and ureteroscopic lithotripsy in treatment of upper ureteral calculi

摘要:

摘要：目的??探讨应用旁置输尿管导管负压吸引的输尿管硬镜钬激光碎石治疗输尿管上段结石的临床疗效。方法 选取2018年1月－2019年3月该科行输尿管硬镜治疗的输尿管上段结石患者83例，随机分为实验组42例（应用旁置输尿管导管负压吸引的输尿管硬镜钬激光碎石）和对照组41例（旁置输尿管导管的输尿管硬镜钬激光碎石）。比较两组碎石时间、结石上移率、术后结石清除率、术后感染发生率和其他并发症（术后输尿管穿孔、黏膜撕脱等）发生率的差异。对于结石上移至肾盂的病例均一期给予输尿管软镜碎石治疗。结果 两组一般情况[性别、年龄、结石侧别、体质指数（BMI）]、结石最大长径、结石CT值、结石与肾盂输尿管连接处距离比较，差异均无统计学意义（P?>?0.05）。实验组术中结石上移病例9例，对照组术中结石上移病例16例。两组碎石时间、结石清除率、其他并发症发生率比较，差异均无统计学意义（P?>?0.05）；两组结石上移率、术后发热率比较，差异均有统计学意义（P?

Abstract:

Abstract: Objective?To evaluate the efficacy of adjacent ureteral catheter with vacuum suction and ureteroscopic lithotripsy in treatment of upper ureteral calculi.?Methods?83 patients with upper ureteral calculi were selected and treated with ureteroscope from January 2018 to March 2019. Randomly divided into two groups, 42 cases in experimental group (using ureteral catheter with vacuum suction) and 41 cases in control group (using only ureteral catheter). The lithotripsy time, calculi moving up to the pelvis, postoperative stone-free rate, postoperative infection rate, and other complications (ureteral perforation, mucosal avulsion, etc) were compared between the two groups. For patients with calculi moving up to the pelvis, flexible ureteroscopic lithotripsy was performed at the first stage.?Results?The general data (male and female ratio, age, weight, left and right side, BMI index), maximum diameter of calculi, CT value and distance between calculi and ureteropelvic junction were no statistically significant (P?﹥?0.05). 9 cases of calculi were moved up to the pelvis in experimental group and 16 cases in the control group. The lithotripsy time, stone-free rate and other complications (ureteral perforation, mucosal avulsion, etc) were compared between the two groups, the difference were not statistically significant (P?﹥?0.05). The rate of calculi moving up to the pelvis and postoperative fever rate were compared, the difference was statistically significant (P?﹤?0.05).?Conclusion?Adjacent ureteral catheter with vacuum suction and ureteroscopic lithotripsy in treatment of upper ureteral calculi have applied value, especially suitable for primary hospitals without flexible ureteroscope, ureteral occluder and basket.