peel-away鞘辅助下输尿管镜碎石术与单用输尿管镜碎石手术在女性输尿管下段结石治疗中的应用

Application of Peel-away sheath assisted ureteroscopic lithotripsy and ureteroscopic lithotripsy alone in the treatment of female lower ureteral stones

目的分析peel-away鞘辅助下输尿管镜碎石术与单用输尿管镜碎石手术在女性输尿管下段结石治疗中的应用。方法将71例女性输尿管下段结石患者按手术方式不同分为观察组(n=30,peel-away鞘辅助下输尿管镜碎石术)与对照组(n=41,单用输尿管镜碎石手术);比较两组一般手术情况、结石清除率、肾功能水平及术后并发症发生率。结果两组术中失血量、结石直径、住院时间及术后1月时的结石清除率比较差异无统计学意义(P>0.05),观察组手术时间短于对照组、术后3 d结石清除率高于对照组(P<0.05);两组术后血肌酐(Scr)、血清胱抑素C(CysC)、明胶酶相关脂质运载蛋白(NAGL)水平较术前均上升,观察组Scr、CysC、NAGL水平低于对照组(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论较单纯输尿管镜碎石手术,peel-away鞘辅助下输尿管镜碎石术更利于早期结石清除,对肾功能的影响更小,且安全性良好。

Objective To analyze the application of Peel-away sheath assisted ureteroscopic lithotripsy and ureteroscopic lithotripsy alone in the treatment of female lower ureteral stones.Methods Seventy-one female patients with lower ureteral stones admitted to our hospital were divided into observation group(n=30,Peel-away sheath assisted ureteroscopic lithotripsy)and control group(n=41,ureteroscopic lithotripsy alone).General conditions of surgery,stone clearance rate,renal function and incidence of postoperative complications were compared between the two groups.Results There was no significant difference in blood loss,stone diameter,length of hospital stay or stone clearance rate after 1 month of surgery(P>0.05).However,the operation time of the observation group was significantly shorter than that of the control group and the stone clearance rate after 3 days of surgery was significantly higher than that of the control group(P<0.05).Serum creatinine(Scr),serum cystatin C(CysC)and neutrophil gelatinase-associated lipocalin(NAGL)in both groups were increased significantly after surgery and they were significantly lower in the observation group than those in the control group(P<0.05).The total incidence of complications was lower in the observation group than that in the control group(P>0.05).Conclusion Compared with ureteroscopy alone,Peel-away assisted ureteroscopy is more beneficial to the removal of early calculi with less impact on renal function and safety is good.