智能控压的输尿管软镜吸引取石术治疗肾结石的临床研究

Clinical study of flexible ureteroscope lithotripsy by intelligent pressure control treating renal calculus

目的探讨有无负压吸引输尿管软镜碎石技术治疗肾结石的临床效果。方法将已获专利的可测量肾盂压力的输尿管软镜吸引鞘(简称测压吸引鞘)及腔内灌注吸引压力监测控制平台(简称平台)设备与传统输尿管镜鞘进行比较,对2016年1月~2017年3月我科室收治的96例直径<2 cm的肾结石患者的临床资料进行分析、比较,其中使用测压吸引鞘连接压力监测控制平台的智能监控肾盂内压治疗组的患者(A组)48例,无负压吸引的输尿管镜鞘治疗组的患者(B组)48例,比较两组患者的术前、术后相关指标。结果 A组患者的手术时间短于B组,清石率明显高于B组,差异有统计学意义(P<0.05);术前,两组的血清降钙素原(PCT)及内毒素(ET)水平比较,差异无统计学意义(P>0.05);术后,两组24 h内的PCT及ET水平差异有统计学意义(P<0.05)。结论在预防肾盂高压及提高碎石清石率方面,有压力监控及调节在输尿管软镜治疗肾结石中的效果显著、优势明显。

Objective To explore the clinical effect of flexible uretroscopy lithotripsy treating renal calculus with or without pressure suction.Methods Patented measurable pressure of the renal pelvis ureteroscopic attraction sheath （abbreviated as pressure measuring sheath） and intraluminal perfusion pressure monitoring and control platform （abbreviated platform） equipment was compared with traditional ureteroscopic sheath.Clinical data of 96 patients with renal calculus （diameter〈2 era） treated in our department from January 2016 to March 2017 was analyzed and compared.Among them,group A （n=48） and group B （n=48） was given the platform monitoring and regulating renal pelvic cavity irrigation pressure with suetioning sheath and traditional sheath without pressure suction respectively.The related indexes before and after operation were compared in patients between the two groups.Results The operation time in group A was shorter than that in group B,and the stone clearance rate was significantly higher than that of group B,and the difference was statistically significant （P〈0.05）.Before operation,serum procalcitonin （PCT） and endotoxin （ET） between the two groups were not statistically significant difference （P〉0.05）,after operation,there was a statistical difference of PCT and ET level within 24 hours between the two groups （P〈0.05）.Conclusion Flexible ureteroscopy lithotripsy applied to the patented platform monitoring and regulating renal pelvic cavity irrigation pressure with suctioning sheath has the obvious effect and a significant advantage of preventing the high pressure of renal pelvis and increasing the percentage of clear- ance rate.