内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石疗效评价(1)
【摘要】 目的 探讨内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石的临床疗效。方法 80例输尿管嵌顿性结石患者， 随机分为对照组和观察组， 各40例。对照组给予200 μm光纤钬激光碎石治疗， 观察组给予内置4F输尿管导管低压注水灌洗联合输尿管硬镜200 μm光纤钬激光碎石治疗。比较两组患者手术时间、住院时间、并发症发生情况、随访输尿管狭窄情况及结石残留、结石逃逸、术后高热情况。结果 观察组手术时间(43.12±3.11)min短于对照组的(56.13±3.36)min， 结石残留发生率2.50%、结石逃逸发生率2.50%、术后高热发生率2.50%均低于对照组的25.00%、20.00%、17.50%， 差异有统计学意义(P<0.05)。观察组输尿管损伤及术后感染发生率均低于对照组， 差异有统计学意义(P<0.05);两组随访输尿管狭窄发生率及住院时间比较差异无统计学意义(P>0.05)。结论 内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石的临床疗效确切， 手术安全可靠， 可有效减少并发症， 值得推广应用。
【关键词】 输尿管导管;钬激光;输尿管嵌顿性结石;低压注水灌洗
【Abstract】 Objective To discuss the clinical efficacy of low pressure irrigation with 4F ureteral catheter combined with holmium laser lithotripsy under ureteroscope in the treatment of incarcerated ureteral calculi. Methods A total of 80 patients with incarcerated ureteral calculi were randomly divided into control group and observation group， with 40 cases in each group. The control group was treated with 200 μm micron holmium laser lithotripsy， and the observation group was treated with low pressure irrigation with 4F ureteral catheter and 200 μm micron holmium laser lithotripsy with ureteroscope. Comparison were made on operation time， hospitalization time， occurrence of complications， follow-up of ureteral stricture and residual stones， stones escaping and postoperative hyperthermia between the two groups. Results The observation group had shorter operation time as (43.12± 3.11)min than(56.13±3.36) min in the control group， incidence of residual stones as 2.50%， incidence of stones escaping as 2.50% and incidence of postoperative hyperthermia as 2.50% than 25.00%， 20.00% and 17.50% in the control group. Their difference was statistically significant (P<0.05). The observation group had lower incidence of ureteral injury and postoperative infection than the control group， and the difference was statistically significant (P<0.05). Both groups had no statistically significant difference in incidence of follow-up of ureteral stricture and hospitalization time (P>0.05). Conclusion Low pressure irrigation with 4F ureteral catheter combined with holmium laser lithotripsy under ureteroscope is effective， safe and reliable in the treatment of incarcerated ureteral calculi， and can effectively reduce complications. It is worth popularizing and applying.
【Key words】 Ureteral catheter; Holmium laser; Incarcerated ureteral calculi;Low pressure irrigation
作者單位：515300 普宁华侨医院泌尿外科
输尿管嵌顿性结石在临床比较常见， 其中大部分病例通过药物疗法、体外冲击波碎石治疗无效， 需要手术干预。目前治疗输尿管嵌顿性结石的微创手术方法较多， 主要有经皮肾镜取石术(PCNL)、经腹腔镜输尿管切开取石术(RLU)及经尿道输尿管(软)镜碎石术， 其中输尿管镜钬激光碎石术已成为治疗输尿管嵌顿性结石的首选方法[1]。本文选取40例输尿管嵌顿性结石患者分析内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石的临床疗效， 现报告如下。, 百拇医药(连乐林 张育周 赵让加 张俊鑫 黄志雄)
【关键词】 输尿管导管;钬激光;输尿管嵌顿性结石;低压注水灌洗
【Abstract】 Objective To discuss the clinical efficacy of low pressure irrigation with 4F ureteral catheter combined with holmium laser lithotripsy under ureteroscope in the treatment of incarcerated ureteral calculi. Methods A total of 80 patients with incarcerated ureteral calculi were randomly divided into control group and observation group， with 40 cases in each group. The control group was treated with 200 μm micron holmium laser lithotripsy， and the observation group was treated with low pressure irrigation with 4F ureteral catheter and 200 μm micron holmium laser lithotripsy with ureteroscope. Comparison were made on operation time， hospitalization time， occurrence of complications， follow-up of ureteral stricture and residual stones， stones escaping and postoperative hyperthermia between the two groups. Results The observation group had shorter operation time as (43.12± 3.11)min than(56.13±3.36) min in the control group， incidence of residual stones as 2.50%， incidence of stones escaping as 2.50% and incidence of postoperative hyperthermia as 2.50% than 25.00%， 20.00% and 17.50% in the control group. Their difference was statistically significant (P<0.05). The observation group had lower incidence of ureteral injury and postoperative infection than the control group， and the difference was statistically significant (P<0.05). Both groups had no statistically significant difference in incidence of follow-up of ureteral stricture and hospitalization time (P>0.05). Conclusion Low pressure irrigation with 4F ureteral catheter combined with holmium laser lithotripsy under ureteroscope is effective， safe and reliable in the treatment of incarcerated ureteral calculi， and can effectively reduce complications. It is worth popularizing and applying.
【Key words】 Ureteral catheter; Holmium laser; Incarcerated ureteral calculi;Low pressure irrigation
作者單位：515300 普宁华侨医院泌尿外科
输尿管嵌顿性结石在临床比较常见， 其中大部分病例通过药物疗法、体外冲击波碎石治疗无效， 需要手术干预。目前治疗输尿管嵌顿性结石的微创手术方法较多， 主要有经皮肾镜取石术(PCNL)、经腹腔镜输尿管切开取石术(RLU)及经尿道输尿管(软)镜碎石术， 其中输尿管镜钬激光碎石术已成为治疗输尿管嵌顿性结石的首选方法[1]。本文选取40例输尿管嵌顿性结石患者分析内置4F输尿管导管低压注水灌洗联合输尿管硬镜钬激光碎石治疗输尿管嵌顿性结石的临床疗效， 现报告如下。, 百拇医药(连乐林 张育周 赵让加 张俊鑫 黄志雄)