改良截石位在输尿管上段钬激光碎石中的作用研究

The Role of Improvement of Lithotomy Position in Holmium Laser Lithotripsy in the Upper Ureter

目的:探讨改良截石位在输尿管上段钬激光碎石中的作用。方法:前瞻性研究120例钬激光治疗输尿管上段结石,随机分为改良截石位组A组(头高、臀低、健侧倾斜)、B组(头高、臀低)和对照组C组(水平截石位组),各40例。对比分析其单次碎石成功率、住院费用、并发症发生率、手术时间及术后住院天数。结果:ABC三组手术时间逐渐延长,住院费用逐渐增多,术后住院时间逐渐延长,无石率逐渐降低,并发症发生率逐渐增加。三组在使用套石篮例数上逐渐增加。结论:改良截石位组减少结石向上移动的几率,减少套石蓝的使用率,进而缩短手术时间,降低并发症发生率,提高单次手术无石率。改良结石位输尿管上段钬激光碎石是可以成为治疗输尿管上段结石的首选方法之一。

Objective：To explore the role of improved lithotomy position in holmium laser lithotripsy in the upper ureter. Method：120 patients who have upper ureteral calculus were randomly divided into group A（high head,low hip,and the healthy side slope）,group B（high head,low hip）and the control group C（normal lithotomy position）,40 cases in each. Success rate of single operation,hospitalization expenses,complications,operation time and postoperative hospitalization days of each group were analyzed. Result：In A,B,C groups,the operation time of each group was extended gradually,hospitalization cost of each group was gradually increased,postoperative hospital stay of each group was was gradually extended,no stone rate of each group was gradually decreased,complications of each group was increased gradually.The cases of using the stone basket of each group was increased gradually. Conclusion：With improved lithotomy position,the rate of stones’moving up is decreased,the rate of using stone basket is reduced,the operation time is shortened,the incidence of complications is reduced,and the rate of single operation without a stone is improved. improved lithotomy position may be choosed as the first choice in management of calculus of upper ureter by holmium laser lithotripsy.