术前留置输尿管支架管对输尿管软镜碎石术疗效的影响

doi:10.16352/j.issn.1001-6325.2022.08.1255

基础医学与临床 ›› 2022, Vol. 42 ›› Issue (8): 1255-1258.doi: 10.16352/j.issn.1001-6325.2022.08.1255

术前留置输尿管支架管对输尿管软镜碎石术疗效的影响

李鑫^#, 陈志刚^#, 张孟冬, 唐浩, 卢晓东, 李保国^*

北京市海淀医院/北京大学第三医院海淀院区泌尿外科, 北京 100080

收稿日期:2022-06-06 修回日期:2022-06-13 出版日期:2022-08-05 发布日期:2022-08-01
通讯作者: ^*libaoguo_hdyy@163.com
作者简介:^#对本文有同等贡献

Influence of preoperative ureteral stenting on the curative effect of flexible ureteroscopic lithotripsy

LI Xin^#, CHEN Zhi-gang^#, ZHANG Meng-dong, TANG Hao, LU Xiao-dong, LI Bao-guo^*

Department of Urology Surgery, Beijing Haidian Hospital/Haidian Section of Peking University Third Hospital, Beijing 100080, China

Received:2022-06-06 Revised:2022-06-13 Online:2022-08-05 Published:2022-08-01
Contact: ^*libaoguo_hdyy@163.com

摘要/Abstract

摘要： 目的探讨术前留置输尿管支架管对输尿管软镜碎石术治疗肾或输尿管上段结石临床疗效的影响。方法选取2018年10月至2021年7月于北京市海淀医院泌尿外科接受输尿管软镜联合钬激光碎石的肾或输尿管上段结石患者256例,根据术前是否留置输尿管支架管分为实验组(n=192)和对照组(n=64),实验组又根据支架管留置时间长短分为长期组(14 d,n=64)和短期组(7 d,n=128)。记录各组一期手术成功率、手术时间、术中出血量、住院时间、术后并发症发生率及结石清除率,并进行比较分析。结果对照组的手术时间及术中出血量明显高于实验组,组间比较有显著差异(P＜0.001)。留置支架管短期组的住院时间较长期组短(P＜0.001),但手术时间及术中出血量明显高于长期组(P＜0.001)。对照组的一期手术成功率和结石清除率均低于实验组(P＜0.05),并发症高于实验组(P＜0.001)。留置支架管短期组与长期组的结石清除率无显著差异,不过短期组的手术并发症发生率明显高于长期组(P＜0.05)。结论术前留置输尿管支架管可以提高手术成功率、结石清除率,降低手术并发症和术中出血量,缩短手术时间。

关键词: 肾结石, 输尿管结石, 输尿管软镜碎石术, 输尿管支架管, 疗效

Abstract: Objective To investigate the therapeutic effect of preoperative ureteral stenting on the treatment of renal or upper ureteral calculi with flexible ureteroscopic lithotripsy. Methods From October 2018 to July 2021, 256 patients who had undergone flexible ureteroscopic lithotripsy for renal or upper ureteral calculi in Beijing Haidian Hospital were retrospectively selected. According to whether the patients accepted preoperative ureteral stenting or not, the patients were divided into experimental group (n=192) and control group (n=64), and the experimental group was further divided into long-(14 d, n=64) and short-term (7 d, n=128) group according to the time of preoperative ureteral stenting. The differences in success rate of surgery, operative time, amounts of intraoperative blood loss, length of hospital-stay, incidence of postoperative complications and stone-free rate were analyzed to evaluate the therapeutic effects. Results The operative time and intraoperative blood loss of the control group were significantly higher than that of the experimental group, there was significant difference between the two groups(P＜0.001). The long-term group had longer hospital-stay time (P＜0.001), shorter operative time and less amounts of blood loss (P＜0.001). The success rate of surgery and stone-free rate of the control group were lower than that of the experimental group (P＜0.05), while incidence of postoperative complications was higher than experimental group (P＜0.001). There was no significant difference between the short- and long-term group in the stone-free rate, while the postoperative complications of the short-term group was higher than the experimental group (P＜0.05). Conclusions Preoperative ureteral stenting improves the success rate of surgery operation and the stone-free rate, reduces the postoperative complications and intraoperative blood loss, shorten the operative time.

Key words: kidney calculi, upper ureteral calculi, flexible ureteroscopic lithotripsy, ureteral stenting, therapeutic effect

中图分类号:

R691.9

李鑫, 陈志刚, 张孟冬, 唐浩, 卢晓东, 李保国. 术前留置输尿管支架管对输尿管软镜碎石术疗效的影响[J]. 基础医学与临床, 2022, 42(8): 1255-1258.

LI Xin, CHEN Zhi-gang, ZHANG Meng-dong, TANG Hao, LU Xiao-dong, LI Bao-guo. Influence of preoperative ureteral stenting on the curative effect of flexible ureteroscopic lithotripsy[J]. Basic & Clinical Medicine, 2022, 42(8): 1255-1258.

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术前留置输尿管支架管对输尿管软镜碎石术疗效的影响

Influence of preoperative ureteral stenting on the curative effect of flexible ureteroscopic lithotripsy

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