NTrap阻石网篮与封堵器在输尿管镜钬激光碎石术治疗输尿管上段结石中的应用比较

Application of NTrap stone-resistance basket and occluder in ureteroscopic holmium laser lithotripsy for upper ureteral calculi

目的探讨NTrap阻石网篮与封堵器在输尿管上段结石患者输尿管镜钬激光碎石术(URL)中应用价值的差异。方法选取99例行URL的输尿管上段结石患者为受试对象,随机数字表法分成NTrap阻石网篮组(A组)、封堵器组(B组)和对照组(C组)各33例。C组患者予以单纯URL,A、B两组分别配合NTrap阻石网篮、输尿管结石封堵器治疗。比较3组相关手术指标(术程、术中出血量、总住院时间)、手术成功率、术中结石上移率、术中/术后并发症发生率、术后30d结石完全清除率及术后12个月结石复发率的差异,记录3组治疗前后肾盂积水量变化情况。结果 3组术中出血量、总住院时间及术中、术后并发症发生率比较,差异均无统计学意义(P>0.05)。A、B两组术程明显长于C组(P<0.05),手术成功率及术后30d结石完全清除率也明显高于C组(P<0.05),术中结石上移率及术后12个月结石复发率则明显低于C组(P均<0.05)。术后,3组肾盂积水量均较术前明显降低,且A、B组<C组(P均<0.05)。A、B组上述指标检测结果比较,差异均无统计学意义(P>0.05)。结论NTrap阻石网篮与封堵器均可有效改善输尿管上段结石患者术中结石上移情况,在URL中有较高应用价值。

ObjectiveTo compare the applicative value of NTrap stoneresistance basket and occluder in ureteroscopic holmium laser lithotripsy （URL） for upper ureteral calculi.MethodsA total of 99 patients with upper ureteral calculi who underwent URL were selected as study subjects,and were randomly divided into NTrap stoneresistance basket group （group A,n=33）,occluder group （group B,n=33） and control group （group C,n=33）.Group A,B and C was treated with NTrap stoneresistance basket,occlude,and URL,respectively.The surgeryrelated indicators （operation time,intraoperative bleeding volume,hospital stay）,the success rate,rate of intraoperative stone upper shift,incidence of complications,stone clearance rate and recurrence rate were compared among the three groups.The changes of hydronephrosis before and after treatment were recorded.ResultsThere were no significant differences in intraoperative bleeding volume,hospital stay,and incidence of complications among the three groups （P〉0.05）.The operation time in group A and B were significantly longer than that in group C （P〈0.05）,the success rate and 30d stone clearance rate were significantly higher than those in group C （P〈0.05）,while the rate of stone upper shift and 12month recurrence rate were significantly lower than those in group C （P〈0.05）.After surgery,the hydronephrosis volume was significantly less than that before surgery,and the volume in group A and B were less than that in group C （P〈0.05）.There were no significant differences in the above indicators between group A and B （P〉0.05）.ConclusionBoth NTrap stoneresistance basket and occluder can effectively relieve upper shift of stones in patients with upper ureteral calculi during surgery.They are highly applicable in URL.