摘要
目的探讨经输尿管硬通道下软硬镜钬激光碎石治疗大于20mm肾盂结石的安全性和有效性,并与经输尿管软通道下软镜钬激光碎石术式作比较分析,为临床治疗手段的选择提供参考。方法选取2014年4月至2017年8月德阳市第二人民医院泌尿外科诊治的直径20mm～38mm的肾盂结石118例患者做回顾性分析。对比分析经输尿管硬通道下软硬镜钬激光碎石术与经输尿管软通道下软镜钬激光碎石术治疗此类结石患者的一期通道建立成功率、手术时间、住院时间、结石清除率及并发症的发生情况。结果硬通组一期通道建立成功率为82.81%(53/64),与软通组的79.63%(43/54)差异无统计学意义(P>0.05);硬通组手术时间为(39.9±8.3)min,明显低于软通组的(44.6±7.4)min,差异具有统计学意义(P<0.05);而住院时间两组比较(2.5±0.5d与2.3±0.6d),差异无统计学意义(P>0.05);硬通组术后1天及术后4周的结石清除率分别为84.91%和96.23%,均明显高于软通组的65.12%和76.74%,差异具有统计学意义(P<0.05);两种术式并发症发生率比较差异无统计学意义(P>0.05)。结论相比经输尿管软通道下软镜钬激光碎石术,经输尿管硬通道下软硬镜联合钬激光碎石术一期治疗大于20mm肾盂结石患者具有更大优势,安全性好,疗效明显,手术时间段,结石清除率高,值得临床推广。
Objective To explore the safety and efficacy of flexible ureteroscopic holmium laser lithotripsy under ureteral rigid channel for the treatment of renal pelvis calculuswith a diameterlarger than 20mm, and to compare with the soft endoscopic holmium laser lithotripsy under the ureteral soft channel, in order to provide reference for the choice of clinical treatment. Methods The clinical data of 118 patients with renal pelvis calculi of a diameter of 20mm ~ 38mm who were admitted in the Department of Urology of Deyang Second People's Hospital from April 2014 to August 2017was retrospectively analyzed. The success rate, the time of operation, hospital stay, the clearance of stone and the incidence of complications were compared and analyzed between the treatment of the uretero- scopic holmium laser lithotripsy under the ureteral rigid channel and the soft endoscopic holmium laser lithotripsy under the ureteral soft channel. Results The success rate of the first pass passage of the rigidchannel group was 82. 81%(53/64), which was not significantly different from that of the softchannelgroup of 79. 63%(43/54)(P >0. 05). The operation time of the rigid channel group was (39. 9 ±8. 3) min, which was significantly lower than that of the soft channel group of (44. 6 ± 7. 4 ) min, with statistically significant difference ( P < 0. 05 ). There was no significant difference in the length of hospital stay between the two groups (2. 5 ±0. 5d vs. 2. 3 ±0. 6d)(P > 0. 05 ). The stone clearance rates at a day after operation and 4 weeks after operation in the rigid channel group was 84. 91% and 96. 23% respectively, which were significantly higher than those of the soft channel group of 65. 12% and 76. 74%, with statistically significant difference (P <0. 05). There was no statistically significant difference in the incidence of complications between the two groups (P>0. 05). Conclusions Compared to the soft endoscopic holmium laser lithotripsy under the ureteral soft channel, the first stage treatment of the ureteroscopic hol
作者
廖高源
骆华
LIAO Gaoyuan;LUO Hua(Department of Urology,Deyang Second People’s Hospital Chengdu 618000,Sichuan,China)
出处
《中国性科学》
2019年第3期41-44,共4页
Chinese Journal of Human Sexuality
关键词
输尿管软通道
输尿管硬通道
钬激光
肾盂结石
安全性
效果
Ureteral soft channel
Ureteral rigid channel
Holmium laser
Renal pelvis stone
Safety
Effect
