中国现代手术学杂志2024，Vol.28Issue(2)：145-150,6.DOI:10.16260/j.cnki.1009-2188.2024.02.011
7.5 Fr电子输尿管软镜治疗小负荷上尿路结石的临床观察
Clinical analysis of 7.5 Fr electronic flexible ureteroscopy for small upper urinary stones
摘要
Abstract
Objective To discuss the effect and safety of 7.5 Fr disposable electronic flexible uretero-scope in the treatment of single intrarenal stone or upper ureteral stone with diameter of 1 cm.Methods A total of 400 patients with single ureteral or renal stone,with an average diameter of 1 cm,who underwent sur-gical intervention from June 2021 to December 2022 were divided into the observation group and control group by surgical procedure,with 200 patients in each group,and treated by electronic ureteroscopy with 7.5 Fr and 8.5 Fr disposable flexible ureteroscope combined with holmium laser lithotripsy respectively.During the surgery,9.5/11.5 Fr and 12/14 Fr soft lens sheath were placed in the observation group and control group respectively,holmium laser lithotripsy was performed,and stone basket was applied to remove stones.The perioperative indexes,complications,follow-up results and infection indexes such as white blood cell(WBC)count,neutrophil ratio and C-reactive protein before and after operation were compared between the two groups.Results One-stage sheath placement was succeed in all 200 cases(100％)of the observation group,and was in 151 cases(75.5％)of the control group.Staged surgery was performed in 7 cases,and percutaneous nephroscopic laser lithotripsy was in 42 cases in the other 49 cases of the control group.Postoperative abdominal X-ray showed that stone-free were achieved without residual stones in both groups.The intra-operative blood loss volume was less,the duration of postoperative hematuria,the time of lumbar and abdominal pain and hospital stays were shorter in the observation group than those in the control group,and all differences were statistically significant(P＜0.05).There was no statistical difference in operation time,success rate of ureteroscope placement and stone-free rate between the two groups(P＞0.05).No urinary catheter was placed after surgery,and no infection or urinary sepsis was found in both groups.Postoperative complications(such as abdominal pain,hematuria or bladder irritation)associated with indwelling of ureteral double J tube occurred in 15 cases(7.5％)in the observation group and 73 cases(36.5％)in the control group.There was no significant difference in the incidence of complications and infection indexes(as WBC count,neutrophil ratio and C-reactive protein)between the two groups(P＞0.05).Conclusion Flexible ureteroscopic lithotripsy with 7.5 Fr disposable electronic ureteroscope can achieve high success rate of ureteroscope placement and stone-free rate with mini-trauma,rapid recovery,and it is safe and effective for single renal stone or upper urinary stone with diameter of 1 cm.关键词
上尿路结石/一次性电子输尿管软镜/输尿管软镜碎石术/钬激光Key words
upper urinary calculi/disposable electronic flexible ureteroscope/flexible ureteroscopic lithotripsy/holmium laser引用本文复制引用
谢海平,蔡蔚,龙蠡,杨华伟,谢晓..7.5 Fr电子输尿管软镜治疗小负荷上尿路结石的临床观察[J].中国现代手术学杂志,2024,28(2):145-150,6.基金项目
湖南省自然科学基金项目(2023JJ40509) （2023JJ40509）
长沙市自然科学基金项目(kq2202448) （kq2202448）
