小儿输尿管镜治疗成人输尿管狭窄合并结石的临床效果

Clinical efficacy of pediatric ureteroscopy in the treatment of ureterostenosis with ureteral calculi in adults

目的分析成人输尿管狭窄合并结石应用小儿输尿管镜治疗的临床价值。方法纳入80例深圳市坪山区人民医院2019年1月至2020年5月收治的成人输尿管狭窄合并结石患者,采用随机数字表法分为两组,对照组40例给予成人输尿管镜钬激光碎石治疗,研究组40例应用成人输尿管镜与小儿输尿管镜配合治疗,比较两组一次性进镜成功率、结石清除率、手术时间、双J管留置时间、住院时间、临床疗效及并发症发生情况。结果研究组一次性进镜成功率为100.00%,对照组一次性进镜成功率为85.00%,差异有统计学意义(P<0.05)。术后1个月复查,研究组结石清除率为97.50%,对照组结石清除率为82.50%,差异有统计学意义(P<0.05)。研究组手术时间、双J管留置时间及住院时间均短于对照组(P<0.05)。研究组总有效率为95.00%,高于对照组的75.00%(P<0.05)。研究组并发症总发生率为2.50%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论小儿输尿管镜可提升成人输尿管狭窄合并结石的治疗效果,减少并发症发生,从而加速患者恢复,可推广应用。

Objective To analyze the clinical value of pediatric ureteroscopy in the treatment of ureterostenosis with ureteral calculi in adults.Methods A total of 80 adult patients with ureterostenosis combined with ureteral calculi admitted to the People's Hospital of Pingshan District in Shenzhen City from January 2019 to May 2020 were included in this study.They were divided into two groups by random number table method,and 40 cases in the control group were treated with adult ureteroscopy Holmium laser lithotripsy,while 40 cases in the study group were treated with adult ureteroscopy and pediatric ureteroscopy.The success rate of one-time access,the removal rate of ureteral calculi,operating duration,duration of the double J-tube retention,length of stay,clinical efficacy and the incidence of complications were compared between the two groups.Results The success rate of one-time access was 100.00%in the study group and 85.00%in the control group,and the difference was statistically significant(P<0.05).At one month after operation,the postoperative review showed that the removal rate of ureteral calculi was 97.50%in the study group and 82.50%in the control group,with statistically significant difference(P<0.05).The operating duration,duration of double-J tube retention and length of stay were shorter in the study group than those in the control group(P<0.05).The total effective rate of the study group was 95.00%,which was higher than 75.00%of the control group(P<0.05).The total incidence of complications in the study group was 2.50%,lower than that of 25.00%in the control group,with statistically significant difference(P<0.05).Conclusion In the treatment of ureterostenosis with ureteral calculi in adults,pediatric ureteroscopy can enhance the efficacy and reduce the occurrence of complications,thus accelerating the recovery of patients,which can be promoted and applied.