硕通镜联合钬激光治疗肾盂结石的临床疗效

The Efficacy of Shuotong Jing Combined with Holmium Laser in the Treatment of Renal Pelvis

目的探讨硕通镜联合钬激光治疗肾盂结石的疗效。方法选取昆明医科大学第二附属医院泌尿一区2018年1月至9月在硕通镜联合钬激光治疗的肾盂结石患者64例及输尿管软镜钬激光治疗的肾盂结石患者76例,硕通镜组中男34例,女30例,年龄23～64岁,平均(41.09±7.11)岁,结石直径在0.8～2.0 cm,平均1.2cm,输尿管软镜组中男40例,女36例,年龄25～68岁,平均(43.38±7.81)岁,结石直径在0.7～2.0 cm,平均1.1 cm。所有患者均采用全身麻醉后,在超滑黑色导丝引导下先放入鞘,然后硕通镜及输尿管软镜进入,寻找肾盂结石,将结石击碎,观察两组的手术时间、住院天数、术中出血、结石清除率(治疗1月后)、术后并发症、置鞘成功率等相关情况。结果硕通镜组患者手术平时间(60.84±10.27) min,术中平均出血27.98 mL,结石清除率(治疗1月后) 96.87%(62/64),术后并发症4.68%(3/64);输尿管软镜组手术平均时间(75.05±8.61)min,术中平均出血54.71 mL,结石清除率(治疗1月后) 78.94%(62/64),术后并发症21.05%(3/64)。2组手术时间、术中出血、结石清除率、术后并发症具差异有统计学意义(P<0.05),而住院时间、置管成功率差异无统计学意义(P>0.05)。结论硕通镜碎石术在治疗肾盂结石具有可行性、相对安全、结石清除率较高及感染率低的优点。

Objective To investigate the efficacy of Shuotong Jing combined with holmium laser in the treatment of renal pelvis. Methods Sixty-six patients with pyelonesis treated with Shuotong Jing combined with holmium laser and 76 patients with ureteral calculi treated with ureteroscope and holmium laser were selected from the urinary ward of the Second Affiliated Hospital of Kunming Medical University from January to September 2018. In the Shuotong group,there were 34 males and 30 females, aged 23-64 years old, with an average of (41.09±7.11) years old,with a diameter of 0.8-2.0 cm,an average of 1.2 cm. And there were 40 males in the ureteroscopy group,36 female,aged 25 to 68 years,mean (43.38 ± 7.81) years old, stone diameter of 0.7 ~ 2.0cm, an average of 1.1cm. All patients underwent general anesthesia, and then placed under the guidance of super-sliding black guide wire,then enter the Shuotong Jing and ureteroscope to find the renal calculus,and crush the stone. We observed the operation time, hospital stay, intraoperative bleeding, stone clearance rate (January), postoperative compli cations, success rate of sheathing and other related conditions. Results The operation time of the Shuotong group was 60.84±10.27min, the average intraoperative blood loss was 27.98ml, the stone clearance rate was (16.87%)(62/64), and the postoperative complications were 4.68%(3/64). The ureter was soft. The average operation time of the microscope group was 75.05±8.61min, the average intraoperative blood loss was 54.71ml, the stone clearance rate (January)was 78.94%(62/64), and the postoperative complications were 21.05%(3/64). There were significant differences in operation time, intraoperative bleeding, stone clearance rate, and postoperative complications between the two groups (P < 0.05), but there was no significant difference in hospitalization time and catheterization success rate(P > 0.05). Conclusion Shuotong Jing lithotripsy has the advantages of feasibility, relative safety, high stone removal rate and low infection rate in the treatment of renal pelvis.