江苏大学学报（医学版）2024，Vol.34Issue(4)：301-306,6.DOI:10.13312/j.issn.1671-7783.y230304
输尿管软镜碎石术联合可弯曲负压吸引鞘术后无管化治疗＞2 cm上尿路结石的疗效观察
Clinical efficacy of flexible ureteroscopic lithotripsy with flexible vacuum suction ureteral access sheath and tubeless discharge in the treatment of＞2 cm upper urinary tract calculi
摘要
Abstract
Objective:To investigate the clinical efficacy of flexible ureteroscopic lithotripsy(FURL)using flexible vacuum suction ureteral access sheath(FVSUAS)in the treatment of upper urinary tract calculi＞2 cm,through the combination of crushing and suction technology,without indwelling double J tube before discharge.Methods:Clinical data of 43 patients with＞2 cm upper urinary tract stones treated with FVSUAS during FURL from January 2022 to October 2023 were collected and compared with 40 randomly selected patients treated with conventional FURL during the same period.The trial group chose to undergo FURL with FVSUAS and was discharged from the hospital with removal of the ureteral stent tubes 3 days after the operation.In the control group,conventional ureteral access sheath(UAS)was used,and ureteral stent tubes were routinely placed in place postoperatively,and the ureteral stent tubes were removed under second-stage cystoscopy/ureteroscopy at 4 weeks;general data and perioperative indices of patients of the two groups were recorded,and the postoperative stone-free rate,postoperative complications,and patient satisfaction were obtained.Results:The stone-free rate on the 3rd postoperative day in the trial group was 93.02％(40/43),which was significantly higher than that in the control group of 65.00％(26/40),and the difference was statistically significant(P=0.002).When haematuria,pain,and fever between the trial group and the control group on the 3rd postoperative day was compared,the difference was not statistically significant(P＞0.05);the proportion of haematuria,pain,and fever in the control group at 4 weeks after the surgery was significantly higher than that of the trial group,the difference was statistically significant(all P＜0.05).The difference was not statistically significant(P＞0.05)when comparing the satisfaction of the trial group and the control group at 3 days postoperatively,the satisfaction of the trial group at 4 weeks postoperatively was significantly higher than that of the control group(P＜0.01).Conclusion:FURL in combination with FVSUAS for the treatment of＞2 cm upper urinary tract stones and tubeless discharge with ureteral stent tubes removed 3 days postoperatively achieves high stone-free rate and significantly reduces the incidence of fever,haematuria and pain complications,and it can be concluded that it is a safe and effective treatment modality.关键词
输尿管软镜碎石术/可弯曲负压吸引鞘/术后无管化/＞2 cm上尿路结石Key words
flexible ureteroscopic lithotripsy/flexible vacuum suction ureteral access/tubeless discharge/＞2 cm upper urinary calculi分类
医药卫生引用本文复制引用
蒋晓峰,孟繁超,高国静,廖晓星,李云智,金铭,孟玺,张伟忠,杨江华,程代川,赵盟杰,刘冬..输尿管软镜碎石术联合可弯曲负压吸引鞘术后无管化治疗＞2 cm上尿路结石的疗效观察[J].江苏大学学报（医学版）,2024,34(4):301-306,6.基金项目
北京市科学技术委员会-首都特色专项(Z171100001017131) （Z171100001017131）
北京中医药大学新教师启动基金项目(2021-JYB-XJSJJ089) （2021-JYB-XJSJJ089）
