经尿道负压鞘碎石取石治疗输尿管嵌顿性结石的疗效评价

Evaluation of the efficacy of transurethral lithotripsy with negative pressure sheath in the treatment of ureteral incarcerated calculi

目的:探讨经尿道负压鞘输尿管镜治疗输尿管嵌顿性结石的安全性和有效性。方法:选取2018年8月—2019年12月期间我院收治的108例输尿管嵌顿性结石患者,随机分为两组,应用负压吸引鞘输尿管碎石取石52例(试验组),仅行输尿管镜碎石取石56例(对照组),术中输尿管镜置入F4输尿管导管通过结石嵌顿处直至肾盂,连接测压装置测定术中肾盂内压力,试验组采用输尿管负压吸引鞘,连接负压吸引装置,置入精囊镜行输尿管结石碎石取石,对照组仅行输尿管镜碎石,比较两组患者术中肾盂内压力、手术时间、术后结石清除率、术后发热率(T>38℃)、术后炎症指标(PLT、CRP、WBC)、住院时间及费用。结果:试验组肾盂内压力、术后发热比例以及术后炎症指标(PLT、CRP、WBC)明显低于对照组,术后结石清除率明显高于对照组,差异有统计学意义(P<0.05),手术时间、住院时间及住院费用两组间差异无统计学意义(P>0.05)。结论:经尿道负压鞘输尿管碎石取石治疗输尿管嵌顿性结石安全有效,能明显降低术中肾盂内压力,降低术后炎症反应,提高术后结石清除率,减少术后并发症。

Objective:To investigate the safety and efficacy of negative pressure suction sheath during ureteroscopic lithotripsy in the treatment of ureteral incarcerated calculi.Methods:One hundred and eight cases of incarcerated ureteral calculi inpatients who received ureteroscopic lithotripsy in our hospital from August 2018 to December 2019 were retrospectively analyzed and divided into two groups:experimental group with 52 cases and control group with 56 cases.Patients in the experimental group underwent ureteroscopic lithotripsy with negative epressure suction sheath,while the control group only underwent ureteroscopic lithotripsy.The internal pressure of the renal pelvis,operation time,the stone free rate,incidence of fever,inflammatory markers(PLT,CRP,WBC),hospital stay,hospitalization expenses of the two groups were compared.Results:The internal pressure of the renal pelvis,the postoperative fever cases and the postoperative inflammatory markers(PLT,CRP,WBC)in the experimental group were significantly lower than those in the control group,but the stone free rate was significantly higher than that in the control group(P<0.05).Operation time,hospital stay and hospitalization expenses of the two groups were not statistically significant(P>0.05).Conclusion:It is safe and effective to treat ureteral incarcerated calculi by ureteroscopic lithotripsy with transurethral negative pressure suction sheath,which can significantly reduce the internal pressure of the renal pelvis during the operation,reduce the postoperative inflammation reaction,improve the postoperative stone clearance rate,and reduce the complications after the operation.