预置D-J管分期碎石治疗输尿管嵌顿结石的临床研究

Clinical significance of pretreatment with double J stent indwelling in the treatment of impacted Ureteral Calculi

目的比较一期输尿管镜碎石与预置D-J管后二期输尿管镜碎石治疗嵌顿性输尿管结石的临床效果。方法将96例嵌顿性输尿管结石患者按手术方法的不同分为两组,一期碎石组48例,二期碎石组58例。比较两组一次性清石率、手术时间、术后住院时间、并发症发生率等指标。结果两组比较,二期碎石组一次性清石率及手术时间比较并发症发生率、术后住院时间、住院费用等指标均优于一期碎石组,比较差异均有统计学差异(P<0.05)。结论输尿管硬镜联合输尿管软镜钬激光碎石治疗输尿管嵌顿性结石有良好效果,预先置管可进一步提高临床疗效。

Objective To analyze the clinical effects and safety of ureteroscopic lithotripsy(URL)in the treatment of impacted ureteral calculi by pretreatment with double-J stent indwelling.Methods Ninety-six patients with impacted ureteral calculi were enrolled in the study and were divided into one-stage group and two-stage group(pretreatment with double-J stent indwelling),with 48 patients in each group.The clinical effects and safety of the two groups were compared.Results The operative time and the hospital stay in two-stage group were significantly shorter than that in one-stage group,respectively(P<0.05).The success rate of stone clearance rate within 1 month in one-stage group were lower than that in two-stage group(P<0.05).One-stage group has a higher rate of complications compared with two-stage group(P<0.05).Conclusions Rigid combined with flexible ureteroscopic holmium laser lithotripsy is an effcacious and feasible approach for the treatment of impacted ureteral calculi,pretreatment with double-J stent indwelling can increase calculi clearance and improve efficacy and safety.