江苏大学学报（医学版）2024，Vol.34Issue(4)：307-311,320,6.DOI:10.13312/j.issn.1671-7783.y230305
输尿管软镜与输尿管硬镜联合拦截网篮钬激光碎石术治疗输尿管上段结石的随机对照临床研究
Flexible ureteroscopic holmium laser lithotripsy and rigid ureteroscopic holmium laser lithotripsy with N-Trap in the treatment of upper ureteral calculi:a randomized controlled clinical trial
摘要
Abstract
Objective:To analyze the clinical efficacy of flexible ureteroscopic holmium laser lithotripsy(FURL)and rigid ureteroscopic holmium laser lithotripsy(RURL)with N-Trap in the treatment of upper ureteral calculi.Methods:A total of 92 cases of upper ureteral calculi with a diameter greater than 10 mm admitted to Shanghai TCM-Integrated Hospital,Shanghai University of Traditional Chinese Medicine from October 2021 to April 2023 were selected as research subjects.The cases were randomly divided into FURL group of 46 cases and RURL group of 46 cases.The FURL group received the operation of FURL,while the RURL group received the operation of RURL with N-Trap.The operation success rate between FURL group and RURL group were compared.The surgical time,severe complications,1-month stone clearance rate and 3-month stone clearance rate of the successful operation cases between the FURL group and the RURL group were compared.After dividing the two groups of calculi cases into upper FURL group,lower FURL group,and upper RURL group,lower RURL group based on whether the calculus was above the lower pole of the kidney or not,the indexes mentioned above were compared between the two groups in subgroups.Results:The operation success rate of the FURL group(95.7％)was significantly higher than that of the RURL group(80.4％).The operation success rate of the upper FURL group(96.0％)was significantly higher than that of the upper RURL group(70.8％),while there was no significant difference between the lower FURL group(95.2％)and the lower RURL group(90.9％,P＞0.05).The indexes of the successful operation cases of the two groups were analyzed as follows.The operation duration of the FURL group,the upper FURL group,and the lower FURL group were longer than those of the RURL group,the upper RURL group,and the lower RURL group respectively(P＜0.05).There were no significant differences in the incidence of severe complications between the FURL group,the upper FURL group,the lower FURL group and the RURL group,the upper RURL group,the lower RURL group respectively(P＞0.05).There was no significant difference in 1-month stone clearance rate between the FURL group(84.1％)and the RURL group(67.6％,P＞0.05).The 1-month stone clearance rate of the upper FURL group(83.3％)was higher than that of the upper RURL group(52.9％),while there was no significant difference in 1-month stone clearance rate between the lower FURL group(85.0％)and the lower RURL group(80.0％,P＞0.05).There were no significant differences in 3-month stone clearance rate between the FURL group,the upper FURL group,the lower FURL group and the RURL group,the upper RURL group,the lower RURL group respectively(P＞0.05).Conclusion:Both FURL and RURL are safe operations in the treatment of upper ureteral calculi.For the upper ureteral calculi above the lower renal pole,the success rate and 1-month stone clearance rate are higher with the treatment of FURL than those with the treatment of RURL,it may be implicated that FURL is a better choice than RURL in the treatment of calculi in this segment of upper ureter.For the upper ureteral calculi below the lower renal pole,the success rate and stone clearance rate are similar between FURL and RURL,while the operation time of RURL is shorter than that of FURL.关键词
输尿管结石/输尿管软镜/输尿管硬镜/钬激光碎石Key words
ureteral calculi/flexible ureteroscopy/rigid ureteroscopy/holmium laser lithotripsy分类
医药卫生引用本文复制引用
韩孝洲,赵诚,周明眉,刘剑新,张勇,田长海,刘旺,胡华军..输尿管软镜与输尿管硬镜联合拦截网篮钬激光碎石术治疗输尿管上段结石的随机对照临床研究[J].江苏大学学报（医学版）,2024,34(4):307-311,320,6.基金项目
上海市科学技术委员会自然科学基金(23ZR1460300) （23ZR1460300）
上海市虹口区卫生健康委员会医学科研专项(虹卫2102-03) （虹卫2102-03）
