逆向顺流冲洗拦截法输尿管镜超声碎石术防止结石移位的临床研究

Clinical Study on Reverse Flow Rinsing Intercept Ureteroscopic Ultrasound Lithotripsy in Prevention of Displacement of Ureteral Calculi

目的探讨输尿管镜超声碎石术中应用逆向顺流冲洗拦截法治疗输尿管结石的优越性和安全性。方法回顾性分析我院2013年3月~2017年2月72例输尿管结石,分为观察组和对照组,观察组采用逆向顺流冲洗拦截法超声碎石术,对照组采用常规超声碎石术,对2组手术疗效及术后并发症发生率进行比较。结果观察组手术时间明显短于对照组[(50.1±3.5)min vs.(59.9±4.5)min,t=-10.314,P=0.000];一次性碎石清石率明显高于对照组[91.7%(33/36)vs.58.3%(21/36),χ~2=10.667,P=0.001];拔管后2周微结石(≤3 mm)排清率优于对照组[97.2%(35/36)vs.75.0%(27/36),χ~2=7.432,P=0.006];术后发热率明显低于对照组[8.3%(3/36)vs.33.3%(12/36),χ~2=6.821,P=0.009]。结论在输尿管镜超声碎石术中采用逆向顺流冲洗拦截法能够提高碎石清石率,安全可行,有较好的临床推广价值。

bObjective To investigate the superiority and safety of reverse flow rinsing intercept ureteroscopic ultrasound lithotripsy in the treatment of ureteral calculi. Methods A retrospective analysis was made on clinical date of 72 patients with ureteral calculi in our hospital from March 2013 to February 2017. The patients were divided into either Observation Group or Control Group. The Observation Group was treated with reverse flow rinsing intercept ureteroscopic ultrasound lithotripsy,while the Control Group was treated with conventional ultrasound lithotripsy. The surgical effect and rate of postoperative complications of two groups were statistically analyzed. Results The operation time of the Observation Group was significantly shorter than that of the Control Group[（ 50. 1 ± 3. 5） min vs.（ 59. 9 ± 4. 5） min,t =-10. 314,P = 0. 000]; the one-time calculi removal rate of the Observation Group was higher than that of the Control Group [91. 7%（ 33/36） vs. 58. 3%（ 21/36）,χ~2= 10. 667,P = 0. 001]. The microlithiasis（ ≤3 mm） clearance rate after 2 weeks of extubation of the Observation Group was higher than that of Control Group [97. 2%（ 35/36） vs. 75. 0%（ 27/36）,χ~2= 7. 432,P = 0. 006]. The postoperative fever rate of the Observation Group was lower than that of the Control Group [8. 3%（ 3/36） vs. 33. 3%（ 12/36）,χ~2= 6. 821,P = 0. 009]. Conclusion Application of reverse flow rinsing intercept ureteroscopic ultrasound lithotripsy in the treatment of ureteral calculi can improve the calculi removal and clearance rate,which is safe,feasible,and of great clinical promotion significance.