摘要
目的:探讨负压组合式硬输尿管镜联合输尿管软镜治疗直径>2 cm肾盂结石的应用价值.方法:回顾性分析2016年10月-2019年10月深圳市中医院收治的直径>2 cm肾盂结石患者资料,根据手术方式分为负压组合式硬输尿管镜联合输尿管软镜治疗(联合组)32例,单纯输尿管软镜治疗(软镜组)45例.比较两组患者手术时间、结石清除率、平均住院时间及手术并发症发生率.结果:联合组患者手术时间(129.5±8.4)min,住院时间(3.1±0.8)d,石街发生率6.2%(2/32),术后1例体温>38.5℃,无严重脓毒血症发生,二次手术率6.2%(2/32).软镜组患者手术时间(133.1±4.5)min,住院时间(3.3±0.5)d,术后石街发生率24.4%(11/45),术后8例体温>38.5℃,无严重脓毒血症发生,二次手术率26.6%(12/45).联合组软镜组手术时间短,一次手术结石清除率高,二次手术率低,术后发热及石街发生率低,差异有统计学意义(P<0.05).结论:负压组合式硬输尿管镜联合输尿管软镜治疗直径>2 cm的肾盂结石安全有效,具有手术时间短、康复快、并发症少等优点,值得临床推广应用.
Objective:To evaluate the efficiency and safety of negative pressure rigid ureteroscopy combined with flexible ureteroscopy in the treatment of kidney pelvis stone with major diameter greater than 2 cm.Methods:From October 2016 to October 2019,77 patients with kidney pelvis stone which major diameter greater than 2 cm underwent surgery,45 patients underwent flexible ureteroscopy,and 32 patients underwent negative pressure rigid ureteroscopy combined flexible ureteroscopy at Shenzhen Traditional Chinese Medicine Hospital.The operation time,stone-free rate,hospitalization days after operation and complications were analyzed between the two groups.Results:In 32 patients given negative pressure rigid ureteroscopy combined with flexible ureteroscopy,the average operation time was(129.5±8.4)min,the hospital stay was(3.1±0.8)days,and the incidence of steinstrasse was 6.2%(2/32).One patient had the temperature over 38.5°C,2 patients were given second operation(2/32)and there was no patient with severe sepsis.In 45 patients receiving flexible ureteroscopy,the average operation time was(133.1±4.5)min,the hospital stay was(3.3±0.5)days,and the incidence of steinstrasse was 24.4%(11/45).Eight patients had the temperature over 38.5°C,12 patients were given second operation(12/45),and there was no patient with severe sepsis.The combined group had shorter operation time,less complications and higher stones-free rate than the flexible ureteroscopy group.Conclusion:Negative pressure rigid ureteroscopy combined with flexible ureteroscopy is a safe and effective treatment for kidney pelvis stones with major diameter greater than 2 cm.
作者
刘尚文
王亚东
林峰
LIU Shangwen;WANG Yadong;LIN Feng(Department of Urology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518036,China)
出处
《微创泌尿外科杂志》
2020年第6期376-379,共4页
Journal of Minimally Invasive Urology
关键词
负压组合式硬输尿管镜
输尿管软镜
肾盂结石
negative pressure rigid ureteroscopy
flexible ureteroscopy
kidney pelvis stones
