摘要
目的探讨输尿管支架管不同留置时间对老年输尿管软镜碎石取石术后并发症及净石率的影响,为治疗该病症提供临床参考。方法选取2017年6月-2018年6月于常熟市第一人民医院收治的老年上尿路结石患者80例,随机分为观察组和对照组,每组40例。所有患者均采用输尿管软镜碎石术,术后均留置输尿管支架管引流,观察组留置2周,对照组留置4周。评估并比较2组患者输尿管支架管相关并发症发生率、拔管后4周的净石率、术后6周患者生活质量和术后3个月患者肾功能恢复情况。结果观察组尿路感染和膀胱刺激并发症发生率均明显低于对照组(P<0.05),观察组腰腹疼痛比率以及肉眼血尿比率均低于对照组(P<0.05)。拔管后4周观察组的净石率与对照组的差异无统计学意义(87.5%vs 92.5%,P>0.05)。观察组术后平均生活质量评分明显高于对照组(P<0.05)。术后3个月2组患者肾脏功能差异均无统计学意义(P>0.05)。结论输尿管软镜碎石取石治疗老年患者上段输尿管非嵌顿结石和肾结石留置输尿管支架管2周安全有效,能降低术后相关并发症且不影响净石率,并能提高患者术后生活质量。
Objective To investigate the effect of different indwelling time of ureteral stent on complications and stonefree rate of elderly patients after flexible ureteroscopic lithotripsy,and provide clinical reference for the treatment of the disease.Methods 80 elderly patients in First People’s Hospital of Changshu with upper urinary tract stones treated from June 2017 to June2018 were randomly divided into observation group and control group,40 cases each group.All patients were treated with soft ureter lithotripsy,and drainage catheter was placed after operation.The observation group was kept for 2 weeks and the control group was kept for 4 weeks.The incidence of complications related to ureteral stent,the stone removal rate at 4 weeks after extubation,the quality of life at 6 weeks after operation and the recovery of renal function at 3 months after operation of 2 groups were evaluated and compared.Results The incidence of urinary tract infection and bladder stimulation complications in the observation group were significantly lower than those of the control group(P<0.05),and the incidence of lumbar abdominal pain and gross hematuria of the observation group were lower than that of the control group(P<0.05).4 weeks after extubation,there was no significant difference between the observation group and the control group(87.5%vs 92.5%,P>0.05).The average quality of life score of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in renal function between the two groups 3 months after operation(P>0.05).Conclusion Flexible ureteroscopic lithotripsy is safe and effective for the treatment of upper ureteral non-incarcerated calculi and renal calculi in elderly patients with ureteral stent for 2 weeks.It can reduce postoperative complications without affecting the stone clearance rate and improve quality of life of the patients.
作者
周文俊
范志江
屠文健
丁立
范波
曹文新
Zhou Wenjun;Fan Zhijiang;Tu Wenjian;Ding Li;Fan Bo;Cao Wenxin(Department of Urology,Changshu Hospital Affiliated to Suzhou University(First People's Hospital of Changshu),Changshu,Jiangsu Province,215500,P.R.China;Department of Radiology,Songjiang Central Hospital,Shanghai,201600,P.R.China)
出处
《老年医学与保健》
CAS
2020年第3期468-471,共4页
Geriatrics & Health Care
关键词
老年
输尿管支架管
输尿管软镜
输尿管上段结石
肾结石
净石率
elderly
ureteral stent
flexible ureteroscope
upper ureteral calculi
kidney calculi
stone clearance rate