硕通镜和输尿管镜钬激光在输尿管上段感染性结石疗效对比

Comparison of the efficacy between Shuotongjing and ureteroscopic holmium laser in the upper ureteral infectious calculi

本研究主要探讨了硕通镜钬激光碎石术在输尿管上段感染性结石中的疗效与安全性。分析2018年4月~2019年4月我院诊治的70例输尿管上段感染性结石的诊疗经过,随机分为硕通镜组30例和输尿管镜组40例。分析两组的手术时间、住院时间、术后7 d结石清除率、术后1个月结石清除率、Ⅰ期进镜成功率、Ⅱ期碎石发生率、术后并发症发生率和术后感染指标。硕通镜组患者的手术时间、住院时间显著短于输尿管镜组,Ⅰ期进镜成功率低于输尿管镜组,术后7 d结石清除率(SFR)为93.3%,显著高于输尿管镜组的70%,并发症显著低于输尿管镜组,术后感染指标显著低于输尿管镜组,差异有统计学意义(P<0.05)。Ⅱ期碎石发生率低于输尿管镜组,术后1个月SFR为100%,同样高于输尿管镜组的87%,但差异无统计学意义(P>0.05)。硕通镜在输尿管上段感染性结石治疗可能一种安全有效的手术方式,具有创伤小、并发症少和术后恢复快等特点。

This study mainly explored the efficacy and safety of Shuotongjing holmium laser lithotripsy in infectious stones in the upper ureter. Seventy cases of upper ureteral infectious stones diagnosed and treated in our department from April 2018 to April 2019 were randomly divided into the Shuotongjing group(n=30) and the ureteroscope group(n=40). The operation time, hospital stay, stone free rate(SFR) at 7 days postoperatively, SFR at 1 month postoperatively, success rate of stage Ⅰ endoscopic surgery, incidence of stage Ⅱ lithotripsy, incidence of postoperative complications and postoperative infection indicators were compared between two groups. The operation time and hospital stay in the Shuotongjing group were significantly shorter than those in the ureteroscope group. The success rate of stage I entry was lower than that in the ureteroscope group. SFR at 7 days after surgery was 93.3%, which was significantly higher than that in the ureteroscope group. However, the incidence of complication in the Shuotongjing group was significantly lower than that in the ureteroscopy group, and the postoperative infection indicators were significantly lower than those in the ureteroscopy group. The difference was statistically significant(P<0.05). The incidence of stage Ⅱ lithotripsy in the Shuotongjing group was lower than that in the ureteroscopy group. SFR was 100% 1 month after surgery, which was also higher than 87% in the ureteroscopy group. The difference was not statistically significant(P>0.05). Shuotongjing may be a safe and effective surgical method for the treatment of infectious stones in the upper ureter, with the characteristics of less trauma, less complications and quick postoperative recovery.