[1]闫昆吾**田晓菲蔡猛江青彬万洪磊王朝张婧郭明涛.可弯式负压鞘联合输尿管软镜对比硕通镜和常规输尿管镜同期处理双侧输尿管结石[J].中国微创外科杂志,2026,01(4):218-225.
　Yan Kunwu,Tian Xiaofei,Cai Meng,et al.A Comparative Study of Flexible Negativepressure Sheath Combined With Flexible Ureteroscope Versus Sotnureteroscope and Conventional Ureteroscope in the Simultaneous Treatment of Bilateral Ureteral Calculi[J].Chinese Journal of Minimally Invasive Surgery,2026,01(4):218-225.
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可弯式负压鞘联合输尿管软镜对比硕通镜和常规输尿管镜同期处理双侧输尿管结石()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2026年4期
页码:
218-225
栏目:
临床研究
出版日期:
2026-04-24

文章信息/Info

Title:
A Comparative Study of Flexible Negativepressure Sheath Combined With Flexible Ureteroscope Versus Sotnureteroscope and Conventional Ureteroscope in the Simultaneous Treatment of Bilateral Ureteral Calculi
作者:
闫昆吾**田晓菲蔡猛江青彬万洪磊王朝张婧郭明涛
(邯郸市第一医院泌尿外科，邯郸056000)
Author(s):
Yan Kunwu;  Tian Xiaofei;  Cai Meng;  et al.
Department of Urology, Handan First Hospital, Handan 056000, China
关键词:
负压鞘; 输尿管软镜; 硕通镜; 输尿管结石
Keywords:
Negativepressure sheath; Flexible ureteroscope; Sotnureteroscope; Ureteral calculi
文献标志码:
A
摘要:
目的评估可弯式负压鞘联合输尿管软镜、硕通镜和常规输尿管镜同期处理双侧输尿管结石的疗效和安全性。方法回顾性分析2016年5月~2025年7月151例同期处理双侧输尿管结石患者的临床资料，其中56例采用可弯式负压鞘联合输尿管软镜(软镜组)，52例采用硕通镜(硕通组)，43例行常规输尿管镜(常规组)。疗效指标为术后即刻和3个月结石清除率，安全性指标为手术时间，输尿管损伤程度，术后并发症发生率［包括明显腰痛(疼痛视觉模拟评分>8分)、发热、尿源性脓毒症和恶心呕吐］，术后住院时间。结果硕通组和软镜组术后即刻和术后3个月结石清除率均明显高于常规组［常规组、硕通组和软镜组术后即刻结石清除率分别为60.5%(26/43)、84.6%(44/52)、87.5%(49/56)，P<0.05；术后3个月分别为69.8%(30/43)、90.4%(47/52)、92.9%(52/56)，P<0.05］，硕通组和软镜组间差异无显著性(P>0.05)。输尿管上段结石手术时间软镜组<硕通组<常规组(P<0.05)，中段结石手术时间硕通组<软镜组和常规组(P<0.05)，下段结石手术时间硕通组<软镜组<常规组(P<0.05)。术后明显腰痛发生率硕通组［11.5%(6/52)］和软镜组［8.9%(5/56)］均明显低于常规组［27.9%(12/43)］(P=0.043、0.013)，硕通组和软镜组间差异无显著性(P=0.654)。术后发热发生率硕通组［58%(3/52)］和软镜组［7.1%(4/56)］均明显低于常规组［34.9%(15/43)］(P=0.000、0.001)，硕通组和软镜组间差异无显著性(P=1.000)。3组术中输尿管黏膜损伤、术后恶心呕吐、尿源性脓毒症发生率差异均无显著性(P>0.05)。硕通组和软镜组术后住院时间明显短于常规组(P<0.05)，硕通组和软镜组间差异无显著性(P>0.05)。结论相较于传统输尿管镜，可弯式负压鞘联合输尿管软镜和硕通镜处理双侧输尿管结石术后结石清除率高，并发症发生率低。可弯式负压鞘联合输尿管软镜处理单侧输尿管上段结石的时间更具优势，硕通镜处理单侧输尿管中段和下段结石的时间更具优势。
Abstract:
ObjectiveTo evaluate the efficacy and the safety of flexible negativepressure sheath combined with flexible ureteroscope, Sotnureteroscope and conventional ureteroscope in the simultaneous treatment of bilateral ureteral calculi.MethodsA retrospective analysis was conducted on clinical data of 151 patients undergoing simultaneous treatment for bilateral ureteral calculi between May 2016 and July 2025. Of these patients, 56 patients underwent flexible ureteroscopy with a flexible negativepressure sheath (flexible ureteroscope group), 52 patients underwent Sotnureteroscopy (Sotn group), and 43 patients underwent conventional ureteroscopy (conventional group). Efficacy measures included immediate and 3month calculi clearance rates. Safety measures encompassed operative time, degree of ureteral injury, incidence of postoperative complications ［including significant flank pain (score of Visual Analogue Scale > 8), fever, urosepsis, and nausea/vomiting］, and postoperative hospital stay. ResultsThe calculi clearance rates in the Sotn group and flexible endoscope group were significantly higher than those in the conventional group at both immediately after surgery and 3 months postoperatively ［immediate calculi clearance rates: conventional group 60.5% (26/43), Sotn group 84.6% (44/52), flexible endoscope group 87.5% (49/56), P<0.05; at 3 months: 69.8% (30/43), 90.4% (47/52), 92.9% (52/56), P<0.05］. No significant difference existed between the Sotn and flexible endoscope groups (P>0.05). The operative time for upper ureteral calculi showed flexible endoscope group < Sotn group < conventional group (P<0.05), for midureteral calculi showed Sotn group < flexible endoscope and conventional groups (P<0.05), and for lower ureteral calculi Sotn group < flexible endoscope < conventional group (P<0.05). The incidence of significant postoperative flank pain was significantly lower in both the Sotn group ［11.5% (6/52)］ and the flexible ureteroscope group ［8.9% (5/56)］ as compared to the conventional group ［27.9% (12/43); P=0.043, 0.013)］. The difference between the Sotn and flexible ureteroscope groups was not significant (P=0.654). The incidence of postoperative fever was significantly lower in both the Sotn group ［5.8% (3/52)］ and the flexible endoscope group ［7.1% (4/56)］ as compared to the conventional group ［34.9% (15/43); P=0.000, 0.001］. The difference between the Sotn and flexible ureteroscope groups was not significant (P=1.000). There were no significant differences in the incidence of intraoperative ureteral mucosal injury, postoperative nausea/vomiting, or urosepsis among the three groups (P>0.05). The postoperative hospitalization duration was significantly shorter in both the Sotn group and the flexible ureteroscope group as compared to the conventional group (P<0.05), with no significant difference between the Sotn and flexible ureteroscope groups (P>0.05).ConclusionsCompared to conventional ureteroscopy, the combination of a flexible suction sheath with flexible ureteroscope and Sotnureteroscope achieves a higher calculi clearance rate and lower complication rate in the management of bilateral ureteral calculi. The flexible negativepressure sheath combined with flexible ureteroscope offers superior time efficiency for treating unilateral upper ureteral calculi, while the Sotnureteroscope demonstrates greater time efficiency for managing unilateral mid and lowersegment ureteral calculi.

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备注/Memo

备注/Memo:
基金项目：河北省卫健委2023年度医学科学研究课题计划(20231925)**通讯作者，Email：1749200794@qq.com
更新日期/Last Update: 2026-04-24