输尿管硬镜联合输尿管软镜治疗嵌顿性输尿管上段结石患者的疗效

Evaluation of the effect of ureteroscope combined with rigid ureteroscope in the treatment of incarcerated upper ureteral calculi

目的探讨输尿管硬镜联合输尿管软镜治疗嵌顿性输尿管上段结石患者的疗效。方法选取2017年5月至2019年6月福建省漳州市中医院收治的85例嵌顿性输尿管上段结石患者,根据治疗方法分为对照组(输尿管硬镜钬激光碎石术,42例)和试验组(输尿管硬镜联合输尿管软镜钬激光碎石术,43例),比较两组手术疗效、手术指标及复发率。结果与对照组手术疗效(88.10%)相比,试验组手术疗效(97.67%)高,差异有统计学意义(χ2=4.634,P=0.031);试验组碎石时间为(48.58±13.64)min,结石排净时间为(15.31±3.24)d,术后住院时间为(10.22±2.23)d,均短于对照组的(63.25±14.37)min、(18.25±3.61)d、(13.24±1.68)d,差异有统计学意义(t=4.828、3.954、7.039,P=0.000、0.000、0.000);随访6个月,试验组复发率(2.38%)低于对照组(13.51%),差异无统计学意义(χ2=2.069,P=0.150)。结论输尿管硬镜联合输尿管软镜治疗嵌顿性输尿管上段结石患者的疗效确切,可有效缩短手术时间,提高结石清除率,减少手术损伤,便于患者术后快速康复,且复发率不高,应用价值高。

Objective To investigate the effect of soft ureteroscopy combined with hard ureteroscopy in the treatment of incarcerated upper ureteral stones.Methods Eighty-five patients with incarcerated upper ureteral calculi admitted in our hospital from May 2017 to June 2019 were selected and divided into a control group(ureter hard mirror holmium laser lithotripsy,42 cases)and a test group(ureter Hard mirror+ureter soft mirror holmium laser lithotripsy,43 cases).The surgical efficacy,surgical indicators and recurrence rate of the two groups were compared.Results Compared with the curative effect(88.10%)of the control group,the curative effect(97.67%)of the experimental group was higher,and the difference was statistically significant(χ^2=4.634,P=0.031);the lithotripsy time(48.58±13.64)min and stones in the experimental group The discharge time(15.31±3.24)d,postoperative hospital stay(10.22±2.23)d were shorter than the control group(63.25±14.37)min,(18.25±3.61)d,(13.24±1.68)d,the difference was statistically significant Significance(t=4.828,3.954,7.039,P=0.000,0.000,0.000);after 6 months of follow-up,the recurrence rate of the observation group(2.38%)was lower than that of the control group(13.51%),the difference was not statistically significant(χ^2=2.069,P=0.150).Conclusion Ureteroscopy combined with ureteroscopy is effective in the treatment of incarcerated upper ureteral calculi,which can effectively shorten the operation time,improve the clearance rate of stones,reduce the surgical injury,facilitate the rapid recovery of patients after operation,and have a low recurrence rate and high application value,which is worthy of clinical Promotion.