[1]黎勇林 刘明 刘玉明 蒋丽芳 傅发军**.全流程一次性输尿管软镜负压清石术的初步应用[J].中国微创外科杂志,2023,01(11):839-843.
　Li Yonglin,Liu Ming,Liu Yuming,et al.Preliminary Experience of Application of Full Process Negative Pressure Lithotomy With Disposable flexible Ureteroscope[J].Chinese Journal of Minimally Invasive Surgery,2023,01(11):839-843.
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全流程一次性输尿管软镜负压清石术的初步应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年11期
页码:
839-843
栏目:
临床研究
出版日期:
2023-11-25

文章信息/Info

Title:
Preliminary Experience of Application of Full Process Negative Pressure Lithotomy With Disposable flexible Ureteroscope
作者:
黎勇林 刘明 刘玉明 蒋丽芳 傅发军**
(长沙市中心医院泌尿外科，长沙410004)
Author(s):
Li Yonglin;  Liu Ming;  Liu Yuming;  et al.
Department of Urology, Changsha Central Hospital, Changsha 410004, China
关键词:
泌尿系结石; 输尿管软镜; 负压清石; 输尿管负压吸引鞘
Keywords:
Urinary calculi; Flexible ureteroscopy; Negative pressure lithotomy; Ureteral negative pressure suction sheath
文献标志码:
A
摘要:
目的探讨全流程一次性输尿管软镜负压清石术治疗上尿路结石的有效性和安全性。方法回顾性分析2021年1月~2022年11月我科95例上尿路结石的临床资料，其中全流程一次性输尿管软镜负压清石术45例(治疗组)，一次性输尿管软镜联合取石网篮术50例(对照组)，比较2组手术效果(结石清除率、手术时间)、并发症(输尿管损伤、感染)、住院费用、术后输尿管狭窄等。结果治疗组手术时间(52.4±11.9)min，明显短于对照组(67.6±17.0)min(t=-5.083,P=0.000)。治疗组和对照组输尿管损伤［6例(13.3%) vs.3例(6.0%)， χ2=0.753 P=0.385］、术后感染［1例(2.2%)vs.4例(8.0%), χ2=0.639，P=0.424］发生率差异无显著性。治疗组术后即刻清石率显著于对照组［88.9%(40/45)vs.70.0%(35/50)， χ2=5.084，P=0.024］，2组术后4周清石率差异无显著性［93.3%(42/45)vs.92.0%(46/50)， χ2=0.000，P=1000］。治疗组住院费用显著低于对照组［(17 403.2±2668.8)元vs.(19 961.3±1075.6)元，t=-6.241，P=0.000］。治疗组和对照组术后输尿管狭窄发生率差异无显著性［2例(4.4%)vs.3例(6.0%)， χ2=0.000，P=1.000］。结论全流程一次性输尿管软镜负压清石技术治疗上尿路结石安全、有效，为大体积(＞2 cm)上尿路结石、结石合并感染等患者的治疗提供新的选择。
Abstract:
ObjectiveTo explore the effectiveness and safety of full process negative pressure lithotomy with disposable flexible ureteroscope in the treatment of upper urinary tract calculi.MethodsClinical data of 95 patients who underwent surgical treatment in this hospital from January 2021 to November 2022 were retrospectively analyzed. Among them, 45 patients were treated with full process negative pressure lithotomy with disposable flexible ureteroscope (treatment group), and 50 patients were treated with disposable flexible ureteroscope combined with stone retrieval basket (control group). The operation effect (stone removal rate, operation time), complication rate (ureteral injury, infection), hospitalization cost and postoperative ureteral stenosis rate of the two groups were compared.ResultsThe operation time was significantly shorter in the treatment group than that in the control group ［(52.4±11.9) min vs. (67.6±17.0) min, t=-5.083, P=0.000］. The incidence of ureteral injury ［6 cases (13.3%) vs. 3 cases (60%), χ2=0.753, P=0.385］ and postoperative infection ［1 case (2.2%) vs. 4 cases (8.0%), χ2=0.639, P=0424］ was not significantly different. The immediate stone clearance rate was significantly higher in the treatment group than that in the control group ［88.9%(40/45) vs. 70.0%(35/50), χ2=5.084, P=0.024］, and stone clearance rate at 4 weeks after operation had no significant difference between the two groups ［93.3%(42/45) vs. 92.0%(46/50), χ2=0.000, P=1.000］. The hospitalization expenses were significantly lower in the treatment group than those in the control group ［(17 403.2±2668.8) yuan vs. (19 961.3±1075.6) yuan, t=-6.241, P=0.000］. The incidence of postoperative ureteral stenosis had no significant difference between the two groups ［2 cases (4.4%) vs. 3 cases (6.0%), χ2=0.000, P=1.000］.ConclusionFull process negative pressure lithotomy with disposable flexible ureteroscope is safe and effective in the treatment of upper urinary tract calculi, and it is expected to provide a new choice for the treatment of large volume (> 2 cm) upper urinary tract calculi and calculi with infection.

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备注/Memo

备注/Memo:
基金项目：长沙市中心医院科研项目（YNKY202309）**通讯作者，Email：15084997928@163.com
更新日期/Last Update: 2024-02-06