不同软镜治疗髓质海绵肾肾结石的疗效分析

Efficacy and safety of holmium laser lithotripsy using different flexible ureteroscopes for medullary sponge kidney stones

目的探讨末端可弯输尿管硬镜和电子输尿管软镜钬激光治疗髓质海绵肾肾结石的有效性和安全性。方法回顾分析我院2015年1月至2018年1月应用末端可弯输尿管硬镜(孙氏镜)与Olympus电子输尿管软镜联合钬激光治疗的18例髓质海绵肾肾结石患者的临床资料,其中8例采用孙氏镜,10例采用电子输尿管软镜,采用Fisher确切概率法或独立样本t检验比较2组手术时间、上镜成功率、碎石成功率、术后住院时间、术后3个月清石率、并发症等指标的差异。结果孙氏镜组在手术时间方面优于电子输尿管软镜组[(62.6±8.8)min vs(72.8±7.5)min],2组比较差异有统计学意义(t=2.513,P<0.05);电子输尿管软镜在图像清晰度方面优于孙氏镜;电子输尿管软镜组和孙氏镜组患者在术后并发症、上镜成功率、碎石成功率、术后住院时间、术后3个月清石率等方面比较差异均无统计学意义(P>0.05)。结论末端可弯输尿管镜和电子输尿管软镜联合钬激光治疗髓质海绵肾肾结石均安全、有效。

Objective To compare the efficacy and safety of holmium laser lithotripsy using integrated flexible and rigid ureteroscope and electron ureteroscope in the treatment of medullary sponge kidney stones.Methods Eighteen patients with medullary sponge kidney stones were treated by holmium laser lithotripsy using either electron flexible ureteroscope(10 cases,group A)or integrated flexible and rigid ureteroscope(8 cases,group B)from January 2015 to January 2018.The Fisher's exact probability method and independent samples t-test was used to compare the differences between the two groups in operation time,complication rate,successful rate of endoscopic insertion,successful rate of lithotripsy,postoperative hospital stay,and stone-free rate.Results Operation time was significantly different between the two groups([62.6±8.8]min vs[72.8±7.5]min,t=2.513,P<0.05).Electron flexible ureteroscope had better visualization than integrated flexible and rigid ureteroscope.There were no significant differences between the two groups in complication rate,successful rate of endoscopic insertion,successful rate of lithotripsy,postoperative hospital stay,or stone-free rate(P>0.05).Conclusion Both integrated flexible and rigid ureteroscope and electron ureteroscope are safe and effective in the treatment of medullary sponge kidney stones.