输尿管硬镜碎石术与软镜碎石术术后尿道狭窄临床研究

Clinical Research of Postoperative Urethral Stricture between Ureteroscopy Lithotripsy and Flexible Ureteroscopy Lithotripsy

目的:输尿管结石患者分别采用输尿管硬镜碎石术与软镜碎石术治疗,评价术后尿道狭窄发生及治疗情况。方法:256例输尿管结石患者,按照随机数字表法分为两组,分别采用输尿管硬镜碎石术(A组)148例和软镜碎石术(B组)108例手术,中位随访时间为36个月。结果:两组患者术后尿道狭窄发生率(A组25例,B组8例),A组显著高于B组(P<0.05),且A组患者尿道狭窄段更长(P<0.05)。患者采用了尿道扩张或内镜下冷刀切开手术治疗,手术效果良好,而B组患者最大尿流率改善更加显著(P<0.05)。结论:两种手术方式在术后尿道狭窄发生率方面,输尿管软镜组患者发生率更低,且在改善尿道狭窄病情及获得良好疗效方面更具优势。

Objective：To assess the postoperative urethral stricture between ureteroscopy lithotripsy and flexible ureteroscopy lithotripsy for ureteral calculi.Method：256 cases of ureteral calculi were randomly divided into two groups.148 cases underwent ureteroscopy lithotripsy（A group）,and 108 cases underwent flexible ureteroscopy lithotripsy（B group）.They were followed up（median follow-up=36 months）.Result：25 cases occurred urethral stricture in A group,and 8 cases occurred urethral stricture in B group,A group was significantly higher than that of B group（P〈0.05）.And the length of urethral stricture were significantly extended in A group compared with B group（P〈0.05）.The patients underwent urethral dilatation or internal urethrotomy, and the effect were satisfactory,the maximum urine flow rate were significantly better in B group（P〈0.05）.Conclusion：In the aspect of postoperative urethral stricture,A group was significantly higher than that of B group.It has a better effect in improving the condition of urethral stricture and obtaining good treatment effect.