末端可弯输尿管镜在嵌顿性输尿管上段结石治疗中的应用

Application of tip-flexible ureteroscope treatment in impacted upper ureteral calculi

目的探讨末端可弯输尿管镜(孙氏镜)在嵌顿性输尿管上段结石治疗中的疗效。方法嵌顿性输尿管上段结石病人61例,分为两组,观察组34例,采用末端可弯输尿管镜治疗,对照组27例,采用后腹腔镜输尿管切开取石术治疗。分析两组病人的临床疗效。结果观察组术中出血量为(6.76±2.43)ml、手术时间为(58.85±35.30)分钟、住院时间(11.76±4.02)天,对照组分别为(16.85±9.11)ml、(150.93±54.69)分钟、(15.26±2.92)天,两组比较差异有统计学意义(P<0.05)。观察组术后出现并发症5例(14.71%),对照组4例(14.81%),差异无统计学意义(P>0.05)。观察组4周结石结石清除33例(97.06%),对照组26例(96.30%),两组比较差异无统计学意义(P>0.05)。结论孙氏镜治疗嵌顿性输尿管上段结石,安全可行,其碎石疗效确切,并能减小病人创伤,缩短住院时间。

Objective To explore the treatment effect of tip-flexible ureteroscope treatment in impacted upper ureteral calculi.Methods 61 cases of impacted upper ureteral calculi were selected as the research object,which divided into either the study group(treatment with tip-flexible ureteroscope,n=34)and the control group(treatment with retroperitoneal laparoscopic ureterolithotomy,n=27),and their clinical data was analysised.Results The amount of bleeding(6.76±2.43)ml 、the operative time(58.85±35.30)min and hospitalization time(11.76±4.02)d in the study group were less than that of the control group [(16.85±9.11)ml,(150.93±54.69)min and(15.26±2.92)d],and the difference was statistically significant(P<0.05).Postoperative complications in the study group(5 cases,14.71%)were lower than those in the control group(4 cases,14.81%),and the difference was not statistically significant(P>0.05).The rate of stone clearance in the study group(33 cases,97.06%)was higher than that in the control group(26 cases,96.30%),but the difference was not statistically significant(P>0.05).Conclusion Strictly grasp the indications of treatment,Sun’s ureterorenosop is used for the treatment of impacted upper ureteral calculi,which is safe and feasible.The effect of the lithotripsy is accurate,and it can reduce the trauma of the patients and shorten the time of hospitalization.