[1]王珩,徐向军,张海涛,等.逆向顺流冲洗拦截法输尿管镜超声碎石术防止结石移位的临床研究[J].中国微创外科杂志,2017,17(10):913-929.
　Wang Heng,Xu Xiangjun,Zhang Haitao,et al.Clinical Study on Reverse Flow Rinsing Intercept Ureteroscopic Ultrasound Lithotripsy in Prevention of Displacement of Ureteral Calculi[J].Chinese Journal of Minimally Invasive Surgery,2017,17(10):913-929.
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逆向顺流冲洗拦截法输尿管镜超声碎石术防止结石移位的临床研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年10期
页码:
913-929
栏目:
临床研究
出版日期:
2017-10-20

文章信息/Info

Title:
Clinical Study on Reverse Flow Rinsing Intercept Ureteroscopic Ultrasound Lithotripsy in Prevention of Displacement of Ureteral Calculi
作者:
王珩; 徐向军; 张海涛; 刘兆飞; 毛鹏飞; 孙晓青①; 王军起①; 聂锐志; 黄永斌*
南京中医药大学连云港附属医院泌尿外科，连云港222000
Author(s):
Wang Heng;  Xu Xiangjun;  Zhang Haitao;  et al.
Department of Urology, Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang 222000, China
关键词:
输尿管结石;  超声碎石; 逆向顺流冲洗
Keywords:
Ureteral calculi; Ultrasonic lithotripsy; Reverse flow rinsing
文献标志码:
A
摘要:
目的探讨输尿管镜超声碎石术中应用逆向顺流冲洗拦截法治疗输尿管结石的优越性和安全性。方法回顾性分析我院2013年3月～2017年2月72例输尿管结石，分为观察组和对照组，观察组采用逆向顺流冲洗拦截法超声碎石术，对照组采用常规超声碎石术，对2组手术疗效及术后并发症发生率进行比较。结果观察组手术时间明显短于对照组［(50.1±3.5)min vs. (59.9±4.5) min，t=-10.314，P=0.000］；一次性碎石清石率明显高于对照组［91.7%(33/36) vs. 583%(21/36)， χ2=10.667，P=0.001］；拔管后2周微结石（≤3 mm）排清率优于对照组［97.2%(35/36)vs. 75.0%(27/36)， χ2=7.432，P=0.006］；术后发热率明显低于对照组［8.3%(3/36) vs. 33.3%(12/36)， χ2=6.821，P=0.009］。结论在输尿管镜超声碎石术中采用逆向顺流冲洗拦截法能够提高碎石清石率，安全可行，有较好的临床推广价值。
Abstract:
ObjectiveTo investigate the superiority and safety of reverse flow rinsing intercept ureteroscopic ultrasound lithotripsy in the treatment of ureteral calculi. MethodsA retrospective analysis was made on clinical date of 72 patients with ureteral calculi in our hospital from March 2013 to February 2017. The patients were divided into either Observation Group or Control Group. The Observation Group was treated with reverse flow rinsing intercept ureteroscopic ultrasound lithotripsy, while the Control Group was treated with conventional ultrasound lithotripsy. The surgical effect and rate of postoperative complications of two groups were statistically analyzed.ResultsThe operation time of the Observation Group was significantly shorter than that of the Control Group ［(50.1±3.5) min vs. (59.9±4.5) min, t=-10.314, P=0.000］; the one-time calculi removal rate of the Observation Group was higher than that of the Control Group ［91.7% (33/36) vs. 58.3% (21/36), χ2=10.667, P=0.001］. The microlithiasis (≤3 mm) clearance rate after 2 weeks of extubation of the Observation Group was higher than that of Control Group ［97.2% (35/36) vs. 75.0% (27/36), χ2=7.432, P=0.006］. The postoperative fever rate of the Observation Group was lower than that of the Control Group ［8.3% (3/36) vs. 33.3% (12/36), χ2=6.821, P=0.009］.ConclusionApplication of reverse flow rinsing intercept ureteroscopic ultrasound lithotripsy in the treatment of ureteral calculi can improve the calculi removal and clearance rate, which is safe, feasible, and of great clinical promotion significance.

参考文献/References:

[1]Farahat YA, Elbahnasy AE, Elashry OM. A randomized prospective controlled study for assessment of different ureteral occlusion devices in prevention of stone migration during pneumatic lithotripsy. Urology,2011,77(1):30-35.
[2]Ding H, Wang Z, Du W, et al. N-Trap in prevention of stone migration during ureteroscopic lithotripsy for proximal ureteral stones: a meta-analysis. J Endourol,2012,26(2):130-134.
[3]韦钢山,黄向华,覃斌,等.两种微创术式治疗输尿管上段嵌顿性结石的疗效比较.广西医学,2012,34(10):1400-1401.
[4]Lee H, Ryan T, Teichman JM, et al. Stone retropulsion during holmium: YAG lithotripsy. J Urol,2003,169(3):881-885.
[5]那彦群，叶章群，主编.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社，2014.255-256.
[6]Wang CJ, Huang SW, Chang CH. Randomized trial of N-trap for proximal ureteral stones. Urology,2011,77(3):553-557.
[7]Sarkissian C, Paz A, Zigman O, et al. Safety and efficacy of a novel ureteral occlusion device. Urology,2012,80(1):32-37.
[8]宗益平,周伟民,秦振乾,等.输尿管镜钬激光碎石术治疗嵌顿性输尿管结石.中国内镜杂志,2011,17(4):423-424,427.
[9]Ahmed M, Pedro RN, Kieley S, et al. Systematic evaluation of ureteral occlusion devices: insertion, deployment, stone migration and extraction. Urology,2009,73(5):976-980.
[10]程波.输尿管镜超声碎石治疗输尿管中上段结石的疗效.吉林医学,2013,34(18):3637-3638.
[11]黄一亮,李超,安黎明.输尿管镜联合封堵器与微创经皮肾镜治疗输尿管上段嵌顿结石的疗效比较.中国微创外科杂志,2014,14(11):1002-1004.
[12]黄永斌，黄晓明，张继邦，等.逆向顺流冲洗拦截法碎石治疗输尿管结石的临床研究.中国内镜杂志,2015,21(7):739-742.
[13]高中伟,刘刚,任小强,等.输尿管结石致急性肾功能衰竭诊治策略(25 例报告).中国内镜杂志,2012,18(3):326-328.
[14]周建国,黄晓明,黄永斌,等.CT值对顺流冲洗拦截法经输尿管镜超声碎石效率的影响.国际泌尿系统杂志,2015,35(5):655-657.

备注/Memo

备注/Memo:
*通讯作者，E-mail：huangyb120@126.com①（徐州医科大学附属医院泌尿外科，徐州221002）
更新日期/Last Update: 2018-01-11