输尿管软镜联合硬镜治疗碎石失败2～3 cm直径上尿路结石

Study on flexible ureteroscope combined with rigid ureteroscope in treatment of 2-3cm of upper urinary tract calculi with lithotripsyfailure

目的探究碎石失败2~3 cm直径上尿路结石采用输尿管软镜联合硬镜治疗效果。方法选择2017年12月至2018年7月本院收治的60例体外震波碎石失败2~3 cm直径上尿路结石患者为研究对象,根据治疗方式不同和患者自愿选择分为对照组和观察组,各30例。对照组采用标准通道经皮肾镜取石术治疗,观察组采用输尿管软镜联合硬镜取石术治疗,比较两组患者治疗效果、手术相关指标、并发症。结果观察组结石取净率、一次性碎石成功率高于对照组,术后复发率、并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组术后住院时间为(8.26±1.85)d、手术时间(86.37±9.41)min、术中出血量为(25.69±3.11)ml,均优于对照组,差异有统计学意义(P<0.05)。结论碎石失败2~3 cm直径上尿路结石采用输尿管软镜联合硬镜治疗可在保证取石成功的基础上,减轻机体创伤性,降低并发症发生率及术后复发率,利于患者术后康复。

Objective To investigate the effects of ureteroscopic and ureteroscopic lithotripsy in treatment of 2-3 cm upper urinary tract calculi with lithotripsy failure. Methods 60 cases of 2-3 cm upper urinary tract calculi with lithotripsy failure in the hospital from December 2017 to July2018 were selected as research objects. All selected cases were divided into control group and observation group according to the treatment methods and patients preference, with 30 cases in each group. Control group underwent standard channel percutaneous nephrolithotomy, and observation group was treated with flexible ureteroscopic and ureteroscopic lithotripsy. The curative effects, surgical indexes and complications were compared between two groups. Results The stone removal rate and success rate of one-time lithotripsy in observation group were higher than those in control group, the recurrence rate and the incidence of complication in observation group were lower than those in control group(P<0.05). The postoperative hospital stays, operation time, intraoperative bleeding volume in observation group [(8.26±1.85) d,(86.37±9.41) min,(25.69±3.11) ml] were better than those in control group(P<0.05). Conclusion On the basis of ensuring the success of stone removal, flexible ureteroscopic and ureteroscopic lithotripsy can reduce trauma, decrease the incidence of complications and recurrence rate, promote postoperative rehabilitation.