一种改良超声碎石探针在高硬度上尿路结石行经皮肾镜碎石术中的临床应用

Clinical application of a modified ultrasonic lithotripsy probe in percutaneous nephrolithotripsy for high hardness upper urinary tract calculi

目的评价一种改良超声碎石探针在高硬度上尿路结石行经皮肾镜碎石术(PCNL)中的临床疗效及安全性。方法选取2017年12月至2018年10月在本院就诊的68例上尿路结石患者,其中输尿管上段结石9例,肾结石59例,所有结石CT值均>1300 Hu,均行PCNL。根据不同的碎石探针分为两组,其中34例应用北京汇福康超声气压弹道碎石系统(CQS-01)常规碎石探针进行碎石治疗(常规探针组),另外34例应用改良超声碎石探针进行碎石治疗(改良探针组),对比分析两组的手术成功率及临床并发症。结果两组患者的手术成功率、结石清除率以及症状缓解率比较,差异无统计学意义(P>0.05);与常规探针组相比,改良探针组的手术时间[(30.11±11.30)min vs.(40.50±10.31)min,P<0.05]和住院时间更短[(4.30±0.14)d vs.(6.58±0.53)d,P<0.05],且无出血、肾盏或肾盂黏膜损伤等临床并发症出现。结论改良超声碎石探针在上尿路结石行PCNL中应用安全有效,可优先选择应用于高硬度上尿路结石患者。

Objective To investigate the clinical efficacy and safety of a modified ultrasonic lithotripsy probe(Patent No.ZL201720748836.9)in percutaneous nephrolithotomy for treatment of upper urinary high hardness calculi.Methods Sixty-eight patients with upper urinary calculi who were treated in our hospital from December 2017 to October 2018 were enrolled,including 9 cases of ureteral stones and 59 cases of kidney stones.The CT values of all stones were more than 1300 Hu.All patients underwent percutaneous nephrolithotomy(PCNL).Of them,34 patients underwent conventional lithotripsy probe of Beijing Huifukang ultrasonic pneumatic lithotripsy system(CQS-01)while 34 patients were performed by modified ultrasonic lithotripsy probe.Each group was compared in terms of the success rate,operation time,stonefree status,symptom-free status,blood loss,mean postoperative hospital stays and postoperative complications.All the data were analysed by chi-square test or t-test(P<0.05).Results There was no statistical difference between the groups for success rate,stonefree status and symptom-free status(P>0.05).The operation time and hospitalization time per patient were(30.11±11.30)minutes and(4.30±0.14)days respectively in the modified ultrasonic lithotripsy probe group,while they were(40.50±10.31)minutes and(6.58±0.53)days in the conventional lithotripsy probe group(P<0.05).Conclusions The new ultrasonic lithotripsy probe in percutaneous nephrolithotomy is safe and effective in the treatment of upper urinary tract calculi.It can be preferentially applied to patients with high hardness upper urinary calculi.